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Radiology/breast mammogram and sonogram

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Hi,
     I am a 51 year old post menopausal woman (LMP 12/2011). I hope you can explain my breast mammo and sono results. Also, I just thought I'd mention that my breasts seem to have gotten a bit lumpy with intermittant pain, within the past 2 years. My prior mammo in 11/2011 showed lump in right breast, I had to re-do mammo and additional sonogram, which found benign tissue with spot compressionin right breast, left breast showed no suspicious findings.
     Fast foward to 01/2013, my new breast mammo and sono are as follows.
     Indication: screening. Mastalgia. Lumpiness in the right lower outer quadrant and left lower outer quadrant.
     Last clinical breast exam 11/09/2011.
     Technique: Bilateral digital CC and MLO views with computer-aided detection. Spot compression views of the bilateral areas of concern. Bilateral whole breast ultrasound.

     Finding:  The breasts are heterogeneously dense. Postsurgiacl changes in the right breast are stable. No suspicious mass or tumor calcifications are seen in either breast. Spot compression views of the areas of concern reveal no abnormality.
     Ultrasound shows no solid mass in either breast. There is a 0.3 cm cyst in the right 12 o'clock axis 3 cm from the nipple.
     IMPRESSION
1.  No evidence of malignancy.
2.  Tiny right 12 o' clock cyst.

BI-RADS 2: Benign.
Recommendation:  Routine annual screening mammography and sonography.
     By the way I injured the middle right side on my right breast, in 1981, and subsequently had a fibrous cyst surgically removed from said area the same year.
     Do these Findings  show anything for me to worry about? Aren't my breasts not supposed to be so dense cause I am postmenopausal and not taking HRT? I told the sonogram tech that both my breasts were rather lumpy when she asked what area concerned me. How can report be so sure that my breast lumps are not cancerous. Should/can I insist on an MRI?
     Thank you for any help. Sofia

Answer
Hello Sofia,

I would say that from the report there are no concerning findings.  Some women even in the postmenopausal time have very dense breasts (which pretty much means a lot of fibrous breast tissue and not a lot of normal fat tissue). It is very individual.  The best way to augment mammorgrams in such cases is self exam on very regular bases. You know your breasts better then anyone. If there is a certain area of concern that has changed in how soft/hard it is or you have nipple discharge or you feel a lump on your underarm, these changes should be investigated further. Your doctor also should take into account breast cancer family history (any woman who was diagnosed with breast cancer before 50 years of age. If you have that history or any other risk factors then i would talk to your doctor about MRI of the breast. Other then that, regular mammograms and self exam will be the key.

Hope this helps.

MK

Radiology

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Michael K.

Expertise

Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...

Experience

12 year experience in the field of radiology

Organizations
American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Publications
Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

Education/Credentials
Board Certified in Diagnostic Radiology Additional Certificate of Qualification in Neuroradiology

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