Case 7 Answer
A focal asymmetry (FA) is present in the lower inner right breast. This is focal because it is seen on both views. It is clearly asymmetric, since there is no comparable density on the left side. However, the density itself does look like breast tissue.
If you said asymmetric breast tissue, this implies that you know with certainty that the density is normal breast tissue. Do we know enough about this finding to say this? Is it stable? Is it palpable?
If you said mass, then you are implying that you are sure this is NOT normal breast tissue. Since the finding looks like breast tissue, this is possible, but less likely. Finally, there is no visible architectural distortion.
What is the work-up for FA's seen at screening?
- FA seen at screening is BI-RADS 2 - Benign - Follow-up in 1 year
- FA seen at screening is BI-RADS 3 - Probably Benign - follow-up in 6 months
- FA seen at screening is BI-RADS 4 - Suspicious - biopsy is recommended
- FA seen at screening is BI-RADS 0 - Incomplete - spot compression magnification mammography and ultrasound are recommended.