Calcification § Density

[gayegjones]

Can someone help what this means?  I am 38 years old and just received the report back from my first mammogram which said I had some calcification with density in my left breast.  My OBGYN wants me to do a diagnostic mammogram as a follow up.  Should I be concerned?  There is no breast cancer history in my family, but my mom has had alot of cysts as well as calcifications.

[CCF-RN,MSN-rf]

Dear gayegjones:  Microcalcifications are small deposits of calcium that can be visualized on an x-ray. A large percentage of microcalcifications have nothing to do with cancer and are probably the result of normal wear and tear on the breast. When they are seen on the mammogram, the radiologist is looking for a pattern. Microcalcifications that are scattered throughout the breast are more likely to represent a benign deposit. Calcifications that are close together may be clustered around a pre-cancer or cancer. The radiologist would usually compare the current film to previous films, look for symmetry, and look at the pattern of these calcifications.

Densities on mammogram are also categorized based on the concern of the radiologist.  Sometimes, tissue can fold over on itself on a mammogram and on a diagnostic mammogram, it will "smooth" out and disappear.  As this is your first mammogram, the radiologist has no previous films with which to
compare so, to be thorough, a diagnostic mammogram has been recommended to further clarify the result.  It is actually quite common to need additional films after a baseline mammogram.  Most of the time, these do not turn out to be cancer.

[surgeon]

calcifications are very common in the breast, and by far mostly due to innocent causes. Cancer can cause them, too, but usually the pattern of calcium is quite recognizeable. It's not at all rare to find them on xray and to have to go through a few steps to be sure what they represent. Sometimes additional xrays with magnification are all that's needed. Sometimes it takes an xray-guided biopsy. It should be pursued; but take comfort in knowing the odds are overwhelmingly favorable.

[gayegjones]

Thank you to "surgeon" who responded.  I am scheduled for a diagnostic mammo with ultrasound on March 7 - so at least it's pretty quick.  The report stated that "the images of the left breast demonstrate a cluster of microcalcifications in the lower inner quadrant anteriorly.  There is an oval density seen in association with the calcification.  Further evaluation with magnification is recommended."  The BI-RAD catelgory is "0" I assume because at this point the original mammo is inconclusive.  Based on the research I've done it most likely is nothing, but if it is cancerous chances are good I caught it really early.  I hope my understanding is accurate.

[surgeon]

Your understanding is accurate. Calcifications associated with an oval density are even more likely benign.

[gayegjones]

really?!?!?  That seems bizarre.  I assume an oval density is not the same thing as a mass or tumor?  Why would it better contribute to my situation as being benign?  I hope this doesn't require your time in writing a dissertation!  You have been very helpful - and reassuring - thank you.

[gayegjones]

By the way - the cluster is 1 cm

[surgeon]

cancer tends to be irregularly shaped because it grows outward in all direction, and has spidery borders. Oval shape is rarely the way cancer looks.

[gayegjones]

I just wanted to say "Thank you" for the time you took to provide me more info.  This is my first time in all this which makes it a little scarey.  I am being diligent and jumping on this to make sure the odds stay overwhemingly in my favor.  Thank you again for your help and I wish you all the best.

[gayegjones]

I wanted to say "thank you" to you, too.  I know you are probably really busy and have many, maybe more important things to do.  Thank you for choosing to give me a little of your time.  It means alot - I wish you the very best.

[gayegjones]

Results from my diagnostic mammo and ultrasound came back and I consider them to be very favorable.  Mammo reads:  "Test confirms the presence of multiple calcifications in the lower inner quadrant of the left breast.  The calcifications are loosely clustered (1 cm) and have a benign radiographic appearance.  Several of the calcifications have lucent centers.  The soft oval tissue mass identified on the outside left mammogram is not confirmed on the spot magnification views.  Six month follow up with magnification recommened." Findings are consistent with ACR category P (probable benign) mammogram, BI-RADS category 3. Baseleine mammo said 1 cm cluster of microcalcifications in association with an oval density.

Ultrasound results: "Ultrasound of the left breat demonstrates no cystic or solid mass.  Six month left mammo with spot magnification views recommended."  Findings are consistent with ACR category P (probable benign) mammogram, BI-RADS category 3.

My OBGYN is sending me to a breast surgeon to review the films and I assume to just confirm the findings since there does seem to be a cluster appearance that we might need to keep track of.  Why else and what questions should I ask?  My mother has fibrocystic disease with calcifications, but no breast cancer in our family.  Sorry for the long note ...thank you