BI-RADS 4 Calcifications, Please help

Hello,
    My anxiety is nuts right now. I had a regular mammogram which I originally was going to skip. they told me I need to do magnified view for right breast. So I did, the report says BI-RADS 4. suspicious calcification right breast further evaluation is indicated with biopsy, these would be amenable to stereo tactic guidance. what does this mean? I am so scared!  I scheduled a app with a general surgeon next Friday.
I am glade I found this forum. What questions should I ask surgeon?

[japdip]

This means that the area of calcifications that was found by the Mammogram needs to be sampled in some way (the biopsy recommended) to determine exactly what it represents. This is routine when something is found that is questionable. Many biopsies done on Calcifications do return a negative (benign) result but it should always be investigated. I'm not sure what questions you might have but I always suggest that you sit down and write down any and everything that you are wondering about. Take this list with you when you see the Surgeon and go down the list with him/her. You might look up the procedure (Stereotactic Biopsy) in search for information about this particular type of biopsy. This is a very good reason to NEVER skip your annual Mammogram .... if there is anything wrong; the earlier you find it the better.   Take care now and don't get over-stressed .... this never helps althoug I realize that we all do it to some extent.   Regards ..

[lkld999]

japdip,
    How do I not get over-stressed, it is so hard. Is there any good strategies or things I can do to get less-stressed?

[japdip]

I don't know .... stay busy, concentrate on making that list of questions and concerns. Remember that no matter how simple of foolish a question may seem to you, write it down and demand an answer; Dr.s have heard everything and will answer IF YOU ASK !! The only foolish question is the one that goes unanswered. Try to push the negative thoughts aside with positive ones .... it's not easy I know but we women can usually handle a lot more than we think we can. Be sure you take someone with you when you see the Surgeon .... an extra pr. of ears is essential as we tend to "not hear" everything, our minds are racing so far ahead of what is being said. You can do it ... we here have all been there at one time.   Kindest regards ... keep in touch.

[lkld999]

japdip , thank you so much for answering my questions and giving me effective suggestions. I received a lot of help from friends and nice people from internet. I feel much more in control and more hopeful now than before.  I just finished my appointment with a surgeon. He gave me a few options. but it is so hard to make a decisions cause they all have pros and cons.  The first option is
doing a core needle biopsy and the leave a metal mark in there, if it is cancer, the metal marker will be used to identify the area. The second option is not to leave the metal mark in there. if it is cancer, I need to the surgery within a week (Doctor said if it was within a week, they can still identify the area). the third option is to do a surgical biopsy which they just remove the area of calcification (about 1 cm, they will remove about a pingpong ball size), this method gives more peace of mind, but is a little more invasive.  I need to make a division. I kind of want to do the no metal marker core needle biopsy, if it is not cancer, then that option is the best, but on the other hand, if it is cancer, then I'd better off just do the surgical biopsy.
I asked what is the odds that the result will be inconclusive, doctor said 0. What is your experience and opinion on this issue? What I worry is that they take the biopsy sample and do the pathology test and tell it is not cancer, do I need to go get the second opinion such as sending my result to mayo clinic? (I am not sure how at the moment though)

Thank you for your help and input

[japdip]

First of all after receiving your Pathology report, no matter by which method, I wouldn't think it necessary to get a second reading of the slides. IF and this is a very large IF .... there is some question after the biopsy then a second reading would be feasible. If however this were the case I'm sure an additional sampling (perhaps the excisional biopsy) would be recommended anyway. There is no harm in the placement of the titanium chip which is inserted thru a needle, thus is very small. This could also be valuable in the future so that the same area would not be questioned and perhaps recommended for biopsy again due to a question as to whether it were a new finding or a result of the biopsy. This is of course if no further treatment is needed following the biopsy. The markers are often used for this reason in addition to the identification for a possible surgery after the biopsy. I'm not sure that the surgery (in case of cancer) could be scheduled within a week and there is also the possibility of an Oncology Consult before surgery which might result in some type of treatment pre-operatively. I'm just mentioning all the possibilities here .... it's possible that none may apply in your case depending on the biopsy results. Hope you aren't more confused now ... Take care ..

[vickiann3054]

I also had a BI-Rads 4 for suspicious calcification's in my left breast and had to go back for magnified views and was sent to a breast surgeon.  Anyway, I chose your first option.  It was painless and now whenever I have my mammograms you can see the little clip they left inside.  I agree with japdip as far as the marker is concerned.  Kind of cool.  My biopsy came back great - no signs of malignancy.  Please keep us updated - I know you will do fine and they are not going to find anything.

[lkld999]

vickiann3054,
   Thank you so much for sharing your experience with me. It makes feel better.  I have a friend who chose the first option, her result was fine, no sings of maligancy, but the metal clip was hurting her in shower, sleeping positions etc. It also cause bleeding inside as well.  That was one of the reasons I was worried. Now, I kind of want to take the second option, but then, I worry about the risks it involves too ...

[roe551]

I just went through the very same thing...my stress level was through the roof.  I had the sterotactic biopsy and the findings were benign...most calcifications are benign, so try and relax.  Believe me it is easier said than done I know..no matter what anyone said to me it didn;t help..But it was all good...

Hoping your biopsy goes well and the results are benign - take it easy you will be fine..Even if the biopsy is positive, it is very early on and should be very treatable.

Roe

[lkld999]

roe551,
   Thank you so much for your information. I am just a ball of worry! My grandmother was a very strong women and lived to her 90s, I don't know why I have not inherit a single strong cell from her! I have read this link about the metal clip, it drove me crazy. http://www.*************.com/breast-cancer/c/question/95513/33479
I think I decided to just go with the biopsy with no metal clip in there.
But sometimes, I feel like I don't want to do this biopsy anymore, I just want to wait ...

[lkld999]

I don't know why the link I posted was replaced with ***********, It should be
************* *******

[lkld999]

the ***** should be *************

[lkld999]

health central

[roe551]

I thought the same thing about the clip, but I guess that is the only way they can define where the previous biopsy was done.  I was not crazy about the idea but the clip is there and that is that I guess..I am having some discomfort now a few weeks after the biopsy but for now I will chalk it up to the healing process.
I hope you make a good decision for yourself and wish you luck....

[vickiann3054]

The clip they place is so small and cannot be felt at all. It is so tiny that I wonder if your friend was actually feeling that are just after effects from the biospy.  I think it is a good marker for future mammograms and like I said early, the biopsy was a breeze.  Please don't be afraid of the marker or the needle biospy.  The surgical biopsy sounds a lot more painful with more healing time.   What does your Dr. say about the clip?

[lkld999]

My Dr. said it is ok to not have the clip put it there, it is just that if it is cancer, I need to to surgeory within a week, so they know where it was.
I have a friend who did biopsy 11 years ago, she did not have a clip in there. One message I found online said she had a metal clip put in her breast (it was not very deep), she felt pain afterwards, after a while, the scar poped open, the clip came out .....

[vickiann3054]

Yikes - How horrible.  My clip was put in pretty dip so that is probably why it has not bothered me.  Keep us posted.

[vickiann3054]

I meant deep  -  not dip :)

[Mae613]

I'm new to this and i was reading your post, and was wondering what were your results after biopsy?  I'm going for my surgery 4/4/11 and I have # heterogeneous calcifications BI-RAD 4.  Im so scared.

[zouzi]

Hi,
When you add your queries on a previous post,people will most likely overlook it,assuming you are just adding another comment to the original poster.
I don't think that you'll get a reply from "kld999" because she might not be still active in our the Forum.
Japdip,has already responded to your original post,please click on the link below
.
http://www.medhelp.org/posts/Breast-Cancer/Heterogeneous-calcifications/show/1491854

I agree with Japdip,tha many suspicious calcifications ,when biopsied turn up benign.
I can understand your anxiety, we all go through that scary time when waiting for a biopsy and the results...but unfortunately there is nothing that we can do about it, except keeping as busy as we can so the time will seem shorter.
If you have any more questions,please keep it on your original thread,where Japdip commented on your post.
Wishing you all the best and especially BENIGN results!
Take care...

[whitemeadow]

A related discussion, metal marker placed in breast biopsy was started.