From the Guidelines
The ultrasound findings of your breasts show only benign fibrocystic changes, which are common and not concerning, and as such, no further intervention is required at this time. The radiologist has classified these results as BIRADS 2, which means benign (non-cancerous) findings with no evidence of malignancy, as indicated by the guidelines outlined in the National Comprehensive Cancer Network (NCCN) clinical practice guidelines in oncology 1. No suspicious solid masses were found, and there was no enlargement of lymph nodes in your armpits. Fibrocystic changes are normal variations in breast tissue that many women experience, often related to hormonal fluctuations. These changes can cause lumpiness, tenderness, or pain in the breasts but are not related to cancer. According to the NCCN guidelines, if the overall imaging findings are classified as BI-RADS category 1–3 (negative, benign, or probably benign) and the clinical assessment is benign, the patient should be clinically reexamined with imaging as needed in 3 to 6 months to assess stability 1.
Some key points to consider include:
- The current findings do not require any additional follow-up or intervention beyond routine screening.
- You should continue with routine breast cancer screening as recommended for your age and risk factors.
- If you experience any changes or symptoms, such as new lumps, pain, or discharge, you should consult your healthcare provider for further evaluation.
- The NCCN guidelines recommend age-appropriate diagnostic mammogram and/or ultrasound may be performed every 6 to 12 months for 1 to 2 years to assess stability, if deemed necessary by your healthcare provider 1.
From the Research
Sonographic Findings
- The sonographic interrogation of both breasts reveals benign fibrocystic changes, with no worrisome solid mass and no axillary lymphadenopathy 2, 3.
- The impression is that there is no sonographic evidence of malignancy, with a BIRADS 2 classification indicating benign findings 4, 5.
Breast Cancer Screening
- Screening mammography is considered the most effective method to decrease breast cancer mortality, with annual mammograms and clinical breast examinations recommended for women over 40 years old 3.
- Breast self-examination has been promoted as a simple method for breast cancer detection, but studies have shown that it does not reduce breast cancer mortality and can lead to unnecessary biopsies and diagnostic procedures 2.
Sonography in Breast Mass Evaluation
- Sonography is useful in evaluating cystic breast masses, and can help differentiate between benign and malignant lesions 3, 4.
- The Stavros sonographic criteria can be used to assess the benignity or malignancy of solid breast masses, with a high degree of accuracy in predicting benignity 4.
- Sonography can also be used to evaluate superficial breast masses, including epidermal inclusion cysts, steatocystoma multiplex, and fat necrosis 6.
Biopsy and Mammography Performance
- A history of benign breast biopsy can affect the interpretive performance of subsequent screening mammography, with reduced specificity and positive predictive value 5.
- The accuracy of mammogram interpretation can be measured using the area under the receiver operating characteristic curve (AUC), with a lower AUC indicating reduced performance 5.