Q: I am a 40 years old female suffering from left breast pain. I was asked to get a mammography done, which revealed that both the breasts had accentuated density, with preserved architecture and prominent fibrous tissue. There are asymmetrical clumped glandular densities seen in the upper and outer and central-retro-areolar, central and inner quadrants of bilateral breasts suggestive of benign engorged fibro-adenosis and fibro-cystic and fibro-adenomata. The breast reveals normal skin thickness with smooth outlines. The nipple-areola complex also appears normal. There is notable irregular and geographic accentuated density seen in the outer and inferior quadrant of the left breast-engorged fibro-adenosis with inflammation and less likely mitoses (BIRADS 4). Sonomammography was performed, which showed subtle accentuated parenchymal echo pattern of bilateral breasts and few admixed hypo echoic and glandular condensations in the notable upper and outer and retro-areolar central and inner quadrants of bilateral breasts suggestive of subtle benign engorged fibro-adenosis and fibro-cystic and fibro-adenomata with the large measuring approx. 7.3.5 mm in size on the right (breasts). The report was shown to a surgeon in a reputed hospital who gave these medicines - Evion (400 mg) once daily, Doloban SR (100 mg) once daily and Primerose oil capsules (thrice daily) for a month. My thyroid and diabetes tests are normal. Am I on the right treatment after mammography? Am I at a risk of breast cancer?

A:You had pain in the left breast and underwent a mammogram and ultra sound of the breast. The ultra sound and mammogram showed an abnormality in the left breast. According to the report, it is BIRADS 4. You still have the pain and the pain is new onset and it is localised to the left breast. No skin changes or changes in the nipple? The surgeon prescribed you vitamins and anti-inflammatory medicines and asked you to come back in a month.

The doctor examining you and looking at the films can give you the final word. When there is a new onset pain and if there is a palpable mass in that area, we need to do further work up. When we see a BIRADS 4 finding in the imaging studies, in general there is about 30% chance that it can be a cancer. Again, you should follow your surgeon's advice, if your pain is persisting and there is a mass in that area, you should consider doing a biopsy (taking a small sample of breast tissue) to rule out a cancer. If there is any concern for breast cancer, it is ideal to find it in its early stage and it will be potentially curable.