Brief Answer:
Assessment of yearly MRI Breast / Under Evaluation

Detailed Answer:
Brief Ans-Assessment of yearly MRI Breast / Under Evaluation

Hi Dear,Thanks for your query to HCM.
Read your query and understood your health concerns.
I feel concerned about your health concerns,especially due to the Family history of
Breast Cancer in your case.
Going by your questions-I would explain to the point about your health concerns-as follows-
Q-1-how is Lymph node reactive in nature if they are getting bigger each year.?
Ans-Continuous Hormonal imbalance which has caused increase in the fibro-glandular tissue with cystic massess extensively present in both the tissues will explain the reactive lymphnode enlargement-may be from subclinical immune reaction to the tissue changes occuring in the breast over a years time.
Mild sublinical infection of the cystic fibro-glandular tissue also may cause the reactive lymph node enlargement in the axillary nodes in your case.

Q-1-a-Especially when I have heterogenous fibroglandular tissues?
Ans-a-Cause of reactivity is exactly this heterogenous fibroglandular dense tissue ,which is reaction to the hormonal imbalances-from the breast tissue.
These are basically tissue changes of a immuno-chemical nature,which ultimately explain the connection and correlation with these benign changes in the breast of yours over a years time,as detected on the MRI study of your breasts.

Q-1-b-and non-enhanced 5 mm cyst in left breast and many similar cysts through out both the breasts?
Ans-b-The very fact that the cysts of the left breast and many similar cysts in both the breasts have not enhanced but are restricted to 5 mm cyst size, shows the benign nature of tissue changes seen along with the heterogenous dens fibro-glandular tissues across both the breasts.And this typical response needs to be correlated to the normal reporting of the MRI as a whole-for this years study.

Q-2-What could be causing the lymph nodes to enlarge and pleural fluid, which was not seen on last MRI?
Ans-Reports on the lumph nodes as enlarged marginally need to be taken in the scenario of the above explanations regarding the reactive changes in the lymph nodes, in response to the increased heterogenous fibroglandular breast tissue with multiple cysts in both the breasts.
Regarding the pleural fluid-increase? -is not the increase of the fluid but explained as physiological amounts and not reported as pathological amounts of fluid quantity.
Normal physiological quantity in any adult is 10-20 ml usually and is also of the same quantity as is explained by the -"Tiny amount of likely physiological, right greater than left pleural fluid. "
So Don't Worry on the MRI reporting which is grossly normal and rest is to be left with the expert doctors to express their report.
Over all meaning of your MRI is -WNL-Within Normal Limits still.

Hope this would help you to plan further treatment with your doctors there.
Welcome for any further query in this regard to ME.

Good Day!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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