BIRAD 4 and microcalcifications

[kobegrace]

Hi, I had my first mammogram a couple of weeks ago and was then sent for a spot compression due to asymmetry and microcalcifications.  After the spot compression I was told that I need a Stereotactic Biopsy for a BIRAD 4 of the left breast.  It shows a 1.5 x 1 cm lobulated density with multiple, scattered, fine microcalcifications which demostrate mild pleomorphism in terms of size, shape and density.  This is located in the upper outer quadrant.  Can anyone tell me what the chances are this might be malignant based on the terminologies used above?  I don't get to have this test done for another week and am trying to educate myself in the meantime.  Thanks!

[japdip]

More than likely ... a shadow can present as a density, sometimes the breast tissue can fold over on itself and be termed as a density however these things wouldn't be "seen" as "lobulated" as you state in the report. This would be something that appears similar to a bunch of grapes. The reason for the biopsy of course is that a definite determination cannot be made by film alone and the finding is truly anyone's guess at this point. Hang in there and take it all one step at a time ... the waiting is always the worst but all of us here have been there and back. Take care now and keep in touch.  

[kobegrace]

Hi, thank you so much for the input!  Is a lobulated area of density automatically considered a mass and if not what criteria would make it a mass?  Thank you again for your time and input!!

[japdip]

A lobulated density need not be malignant in nature but it is usually considered to be more suspicious than a smooth density. Calcifications that are scattered are not always considered indicative of cancer but if they are clustered or observed in certain patterns they do raise suspicion. It's impossible to even venture a guess as to what this density might represent but remember that a good number of biopsies done for calcifications alone return a benign result. The term BIRAD 4 merely means that a biopsy is necessary to determine the true nature of the finding. We wish you the very best with your upcoming biopsy and please let us know your results (this may take 4 to 7 days after the procedure) and don't hesitate to return with any concerns or questions you may have.   Regards ...