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Mammogram showed apparent area of developing density in posterior right upper outer quadrant. What does this indicate?

May 2014
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Practicing since : 2002
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Hello Doctor, I am a 63 year old female with some questions about my annual mammogram results. The radiologist report stated the posterior right upper outer quadrant, there is an apparent area of developing density with some questionable architectural distortion. Asks for additional ML views, spot compression views and probable right breast ultrasound. There are no other masses or suspicious microcalcifications identified in either breast. There are no other areas of architectural distortion.
I am so nervous about what this could maternal grandmother had breast cancer at the age of 36. Please give me some idea of what tbis all means. Thank you
Posted Sat, 24 Aug 2013 in X-ray, Lab tests and Scans
Answered by Dr. Vivek Chail 12 hours later
Thanks for writing in to us.

As mentioned, you had earlier had a history of densities in both breasts with several cysts having been aspirated over the years.
Presently, in your annual mammography reports, in the posterior right upper outer quadrant, there is an apparent area of developing density with some questionable architectural distortion as described by the radiologist. Following the above suspicion a mediolateral (ML) view, compression view and breast ultrasound has also been asked for.

With the above report nothing is yet conclusive. I suggest you to stop worrying and pay attention to the details here.

When a breast is assessed by mammography, any suspicious looking appearances of breast must be evaluated completely. As you have said, your breasts have been described as dense earlier (meaning more of glandular tissues). In this context, it would be essential for your doctor to review earlier mammography reports.

A breast ultrasound on the other hand will give a more clear picture of any cyst or suspicious mass within. Nowadays, a breast ultrasound and mammography are discussed together while reporting in many cancer institutes. I have discussed hundreds of mammography and breast ultrasound images together while making a diagnosis. Hence, your doctor wants to make a clearer diagnosis in you, given the history of breast cysts in the past.

In most hospitals, a standard reporting system known as BI-RADS (Breast Imaging-Reporting and Data System) is followed. Any problem area in the mammography or breast ultrasound may be classified with a BI-RADS score. Further this score indicates the likelihood of risk to breast cancer and management protocols.

Once you know your BI-RADS score, it will be easy to guide if at all there should be any further steps to be taken. BI-RADS classification is different for each imaging modality (Mammography, Breast ultrasound and Breast MRI scan).

Hope your query is answered.
Should there be further queries, please feel free to ask.

Wishing you good health.
Dr Vivek
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