Clustered Microcalcification

[mel43]

I'm very new at this, on July 26th I had a mammogram & was called back for a magnified mommogram. I have been called and told I need to see the surgeon on Aug. 8th to schedule a biopsy. My report read, Clustered Microcalcification of the left breast at 1:00 outer BIRAD-4. So I'm in panic mode, I live in a very Rural area, I'm 43 this is my second mammogram. I'm scared to death, not sure what to expect or what the statistics are. I have had no symtoms until I had the magnified test now my breast is sore and has a burning sensation. Is this normal??
I have very small breast, what should I expect in the up coming weeks. I need help, I'm still trying to understand all of this. Now every ache & pain I feel through out my body I panic. There is no history of breast cancer in my family. There isn't really anyone to talk to here, and the doctors office people don't seem to be the compassionate type of people. Any help/advice would be appreciated.

[CCF-RN,MSN-rf]

Dear mel43:  Microcalcifications are small calcium deposits found within the breast tissue. There are different types of microcalcifications, and based on their pattern on the mammogram it gives the radiologist clues as to their cause. For instance microcalcifications that are more scattered are probably due to a benign (non-cancerous) cause, a "cluster" of microcalcifications may increase concern that there may be an underlying tumor.   A BIRAD 4 category means that there is a suspicious abnormality. Most category 4 abnormalities are benign but may require biopsy since this category can be malignant in 25-50% of cases.  Many women have sore breasts after a mammogram.  The discomfort you are having does is not an indication whether this is a benign or malignant abnormality.

[Avidhiker]

First of all, please relax yourself.  I know it is easier said than done, but do whatever it takes to calm down.

My surgeon told me that 15% of clustered microcalcifications prove to be malignant, so 85% of the time, they are benign. Unfortunately, mine proved to be cancer.  DEFINITELY HAVE A BIOPSY.  Don't ingore a BRAD4.  The earlier you get it, the better the prognosis.  GOOD LUCK.

[mel43]

Thanks for your encouragement, it helps. I think what has me so scared and nervous is there has been 3 years between my mammagrams, reason being is a person is only so much time off work and I have a special needs child that I take to the doctor often and several miles from where we live. So now I'm so scared because I don't know how long it's been there. Has anyone had a burning sensation in their breast before? It's in the same place as this Cluster is at. I'm not sure what to think, I have so many thoughts and feelings going through my head right now.

[mel43]

Forgot something, I said my head is spinning right now. How does a person go about finding a "Breast Specialist"??? Because I haven't had any luck trying to find one. If I type in Breast Specialist I get Plastic surgery, breast enlargements. Not what I'm looking for. I'm scheduled to see a regular surgeon, I wasn't asked I was told when my appointment was.

[Montana girl 06]

It's always scary to be told you need a biopsy. I have had 2 biopsies for microcalcifications that were benign. My understanding is there are no outward signs (such as burning) for calcifications but I'm certainly no expert. I think if you do a search for Breast Specialist cancer you may get the info you want. That doesn't mean you have cancer, it just narrows the search. Also, remember a birad of 4 means they don't know if it is cancer or not, and the odds are strongly in your favor that it is not cancer. But, the only way you'll find out is to have a biopsy. Also, when my doctor called me she automatically set me up to see a surgeon, also. For calcifications they often recommend a stereotactic biopsy which is less invasive. There's a lot of info on the web on the various biopsies. I had one stereotactic biopsy and 5 years before that had a needle localized (or directed) biopsy for calcifications. Both of these biopsies take a day away from work but it's worth it and really not all that bad.

[Montana girl 06]

To clarify my response, Breast Cancer Specialist would be a good way to search to find a specialist. There's lots of info on microcalcifications on the web also. That might answer your questions on burning and such.

[mel43]

Thank you for your comments, it helps to have other people to talk to. I tried finding something on "burning sensation of the breast" but have found nothing. I had it for a couple of days and then it was gone. Any other time I wouldn't of thought much about it, but now I'm wondering.

Thanks

[cyn17]

I have nodules and cysts and feel a burning or pressure in the  specific area, especially right after a mammo, an ultrasound, and before my period. I've had the nodules and cysts for years, but it wasn't until after a biopsy last year, with clip inserted in the area, that I became much more sensitive. I don't believe it's any cause for concern. If you do some reading on nodules, you'll find that many women have pressure/burning in their breasts.

[mel43]

Thank you all for all your help, as I stated earlier I live in a remote rural area and that makes it hard to find someone who understands. You all have been a lot of help and will let you know how it turns out.

Thank you

[teddy1]

hi mel this is teddy1 and i know what u are going thru. i had the same mamo and then the u s and then the biospy and then the cor biopsy. then the lumpeptomy. i have more to tell. but ill wait to hear from u . please dont get nervous. your situation can be fine. i do wish u luck.  if i can be of any support to u . please let me know.

[mel43]

Hi Teddy1, it's nice to hear from someone who understands it's been a bad week for myself and husband and daughter. I try to keep what I can away from my daughter but being 16 she knows a lot, my husband tries hard to understand. I'm just so scared of everything that is going on and not knowing what to expect. I don't know what to ask the surgeon next week when I meet with him for my consultation, I'm still trying to get over the shock of having to have a byopsy.
Would like any advice you can give.

[teddy1]

hi, again. it is now frid eve. and im home. all i do is think about b c .  i had it in 04 . surgery in 05 and chemo finished in sept in 05. im am ok now.  if i can be on any help for you . i would be happy to answer anything u want. i am very honest. and i wish i had someone to ask questions back in 04 . it seems as though no one ever wanted to tell u anything. it is important to know the facts and the truth.  please dont hesitate to ask . and if i know the answers i will surely help .  where do u live . the state at least.  teddy1

[mel43]

I live in the very northern part of Missouri, it's a rural area, farming area. What is a biopsy like? is it painful? the doctors office said something about a wire!!! very confusing for me.

[Happy4825]

Dear Mel:

Many times it is not cancer.  So don't start to worry now.  You will feel better after you speak with your Surgeon. I know that panic feeling I had it when my biopsy showed I had stage one cancer in my right breat.  I decided if I did have cancer I would have the breast removed.  There are so many ways to take care of cancer with out having the breast removed.  My surgeon said if that was what I wanted it was fine with him.  I was glad I had a choice.  I am fine now and take a pill to help keep me free of cancer.  I know the word cancer is scary but it doesn't have too be they do miracles now. If you would like to E-mail me that would be fine.  I would love to help you anyway I can.  ***@****

[cyn17]

Mel, I had a biopsy last summer. I too was very scared. The procedure for me lasted about 1 1/2 hrs. and I did not feel any pain. In my case, the biopsy was on my left breast. So I was laying on my back with a foam wedge under my left shoulder blade and I had my left arm up over my head. There were two very nice nurses that took turns holding my arm steady, as it started shaking after about an hour of having it above my head. That truly was the most difficult part. As for the biopsy itself, first the doctor tried to do an aspiration of the cyst. The cyst was hard, actually a fibroadenoma. The doctor then took about 10 or so tissue samples around the cyst with a core needle. I never felt any pain, just pressure in the area. My results came back benign.

Please note, this will likely not be the last time you have to do this if you have cystic breasts. I just had an MRI on both breasts and awaiting results and visit with surgeon. At first I drove myself nuts with worry (this has been a summer long process of mammo, ultrasound, MRI, etc). Now I'm to a point where I know I'm in control of my thoughts and feelings and will handle whatever comes my way with knowledge and grace. This particular site has been wonderfully helpful. Read everything you can find. Knowledge is power!! I wish you all the best!

[Montana girl 06]

Since you're talking about a biopsy for calcifications and a wire I'm guessing they're talking about a needle (wire) directed (or needle localized) biopsy. I had one a few years ago. They numb the appropriate area of your breast, put your breast in the mammogram machine and try to make you comfortable since you'll have a number a mammograms over a period of 30-60 min. as I remember. They had me sit. They don't use as much pressure as for a normal mammo. Then the radiologist inserted a wire into the tissue to locate the area for the surgeon to remove, taking another mammo every so often to make sure the wire is heading to the correct place. I had two wires inserted. Before you leave they snip the loose end of the wires and tape the ends to your skin. (The wires are really long and at first I thought I'd have them sticking out of my blouse when I left.) The procedure is kind of wierd, (wierd as in I felt like an alien with wires sticking out of me) but not bad. They took a ton of mammograms to get the wires inserted properly. I think they may have somehow marked the area with dye too, I can't remember. It wasn't bad and not painful. Then I went to the surgeon who numbed the area some more, made a small incision and removed the areas. It's amazing how small they made the incision. (one incision about 1" long to remove 2 areas) I sensed a lot of tugging and pulling but not in a way that hurt since I was numb. I was told the numbing medicine I was given tends to make people a little shaky and jittery which was true for me. I've had 3 biopsies and the scars are barely noticeable. I have some scar tissue I can feel, but my breasts don't seem smaller or deformed. (I have fairly small breasts also.) Because a needle directed biopsy involves two proceedures, it took about 2 hours (1 hour for each proceedure) plus a little waiting time in-between, but it's still not bad. I had my husband drive me the 3 blocks between the radiologists office for the first part, and the surgeons office for the surgery. Then you have your husband and family pamper you for the rest of the day while you put your feet up and watch TV or sleep. I can't emphasize enough that just because they sent you to a surgeon right away does NOT mean you have cancer. (Look at me, I've been sent immediately to a surgeon 3 times - all benign.) It just means they need to check out a suspicious area. Remember, most biopsies are benign. It sounds like you're meeting with your surgeon this week. Be sure to write down all your questions. They're usually great about making sure they answer questions. From experience I have found that radiologists tend to scare me half to death with their reports, but then my surgeon puts it in perspective and I feel much better after that apointment. Let us know how it goes.

[mel43]

Can you all give me advice on what kind of questions I need to ask? My mind is still digesting all of this, as for the radiologist they have never spoken or contacted me about anything. I do have their reports, but I had the doctors office fax them to me. Thanks Montanagirl for calming me down on the biopsy part.

[smbclifton]

mel, if it's any help here, I went through this  in 9/2003. my microcalcs were DCIS (ductal carcinoma in situ)- if you are going to have BC, it's the one to have.
mine is in full remission-it had not spread and I only had surgery (mastectomy) and take pills for 5 years.

try to calm yourself. easier said than done. this is not a death sentence. There is a wonderful site www.breastcancer.org
that is informative and so helpful.
-sheila

[Under Forty Pam]

I just got thru the entire stage you are going thru in July.  Mine was DCIS in situ, hopefully you will turn out with no cancer.  The amount of pain involved in a biopsy I believe is related to how good your surgeon is.  Please please find a breast surgeon with years of experience.  My biopsy was with a breast surgeon (2 yrs experience) and I played softball 4 days later.  My lumpectomy surgery was with a different dr. (35 yrs experience) and I felt less pain with that if you can believe it.  My biopsy was about 1 hr in length total, face down on a special table where your breast goes thru a hole.  I am told it is fairly common but scarey as a first time biopsy person too.  A nurse calmed me and told me everything that was going to happen.  Most of the procedure is prep and mammogram type of things.  Measure, films, adjust, films, films, films.  The actual process of taking the biopsy is a 12 second process.  You are in a mammogram type of position (pressure) for about 30 minutes, that is the hardest part, they numb the area and you don't actually feel the biopsy, hope this helps.

[mel43]

Under Forty Pam: I was not given a choice of a sugeon, the doctors office arranged that before calling me. I have been trying to find a breast specialist but have had no luck with that. I know I would feel more comfortable with one, there isn't any that I know of.

[Montana girl 06]

Is the appointment with the surgeon for the actual biopsy, or to discuss the biopsy? As with any type of surgery, it is your option to get a second opinion. I always met with a surgeon before I had a biopsy. Sometimes the surgeon sent me to a radiologist for the actual biopsy. Questions I would ask are, description of the proceedure, how to prepare for it (sometimes you need to stop taking certain vitamins or meds), what to expect afterwards, if you need to limit activity for 1 day or how long, how much tissue they will remove, how long the proceedure will last, how accurate the results of this type of biopsy are, why he recommends this type of biopsy and not another, if you have other options, how many times or how often the surgeon does this type of biopsy. If you're at all uncomfortable, get a second opinion. It's also ok to ask if the surgeon views the biopsy as probably cancer or more likely benign. The surgeon is not God and cannot give a firm answer but can say if most of this type of biopsy turns out benign or not. As a side note on my previous entry on what biopsies are like, the day after some biopsies you do need to ice the area. Some people have trouble with bleeding, but I never did. They usually have you take Tylenol or something similar for pain. I was sore the day of surgery, but Tylenol really helped. I did follow the nurses instructions completely. And, with all 3 biopsies I could do almost all activities the following day except jog and lift heavy items. It took a week before I was totally comfortable jogging but I could walk as much as I wanted.

[Montana girl 06]

My sister-in-law used to be a Radiology Tech doing mammograms and said you can request to speak to the radiologist about your mammograms but I have never requested that. However, last winter I had to wait while the radiologist viewed my mammmos and Ultrasound so I could carry them to my surgeon in another town since that apppointment was for later that same day. That time the radiologist asked if I'd like to review the films and of course I said yes. He grilled me on my family's cancer history (after the tech person had grilled me on it earlier), pointed out the significant increase in calcifications in only 7 months and shook his head and said it was very worrisome. I was so upset by the time I left I had to sit in my car and cry before I could drive home. I was sure I had cancer. (And this was my 3rd biopsy, so you'd think I'd handle it better than that.) I was so thankful I met with the surgeon later that day because he totally calmed me down. And my biopsy a few weeks later turned out benign. I hope your surgeon has a good bed-side manner and can put you at ease.

[mel43]

My appointment Tuesday is to discuss the biopsy, thanks for giving me some good questions to ask him. I know this surgeon he repaired my hernia and he does have a good bedside manner. I'm just so worried, scared and nervous wreck and so on... I think it wouldn't have bothered me so much if it hadn't been so long since my last mammogram. I have always put my daughter as top priority and doing so I haven't kept up with my check-ups. Now I'm very scared about everything.

[Under Forty Pam]

You always have a choice, it is your body.  Try calling a few local hospitals in your area and ask for a referral for a breast surgeon specialist, they should know of some.  What part of Missouri are you in, perhaps a university hospital might have a choice too.

[Under Forty Pam]

I don't suppose you are very near St. Louis.  I found this place.  Washington University School of Medicine
Siteman Cancer Center - Clincal Cancer Center
600 South Euclid Avenue
St. Louis, MO 63110
Phone: [phone]
Fax: [phone]

[mel43]

We live in the very Northern part of Missouri. Not many doctors around here. St. Louis is 5-6 hours away I travel there often because I take my daughter down there to Cardinal Glennon Childrens Hospital. St. Louis has very good doctors, it's just getting off work to go, I was just there a couple of weeks ago to take my daughter down. So if I would have known this then I could of seen someone, but as it turned out they called me when I got back from St. Louis. Kirksville is the nearest facility and there isn't no specialist there, just common doctors,we live in a very remote area and that is why everyone travels miles to doctors.

Melanie

[Under Forty Pam]

You might try calling this place and see if they have some suggestions for your area.

[boninclyde]

Going through some of the same sort of thing. Today I was reading a book, it suggested I call the pathologist and radiologist who examined my reports. So I did. They were very nice. Most people don't actually call the radiologist or pathologist but I did and like I said they was more than happy to talk to me. Look over your reports and get the name then call the facility. Actually I did not call myself I had to get my husband to do it I was scared. I also read you can get a second opion on a pathology report you just have to have the samples sent to a different path. So after the biopsy you don't feel comfortable, get a swecond opion. Tell them you want to know every single detail they know and what they saw when looking at your mamos and path report.

[mel43]

Well I saw my surgeon today, I'm scheduled for my biopsy on Thursday. He said that there is one Cluster and it's concerning, but he would be more concern if there was a mass or lump and there isn't any. But he will take all of the Micro calcification out of my breast, he said he never leaves them in anyone. He has done many of these and he said more than 1/2 of them turn out okay. He said after they put the wires in then they will put me to sleep for the rest of it.
So any comments would be appreciated :-) I'm a nervous wreck, my stomach hurts so bad I could get sick.

[boninclyde]

Someone here can help you relax I hope but not me. I will be having a different type of surgery. Since I found out 4 weeks ago I throw up, shake uncontrollably and cry most of the time. I know your scared I wish there was something we could do. Prayers.

[Montana girl 06]

I'm glad your appointment is on Thursday so you won't have to wait much longer to find out. I agree, prayer is powerful, and without my faith and friends praying for me it would have been more difficult for me. You're in my prayers. And plan for a lazy day on Thursday. Get help with meals or order out. Let your family know you need to be pampered that day. And I've found a Tylenol PM the night before surgery helps me sleep better, too.

[ziggy123]

Can anyone help with this? Do calcifications always occur in the ducts? I have about 8 in a cluster, is this small/large?

[boninclyde]

I had two clusters then some widespread calcifications. One of mine they said has 25 and one about 15. Which dr.'s is quite a bit.

[Under Forty Pam]

I don't believe calcifications are always in the ducts.  I have them spread all over the place.  They were never concerned about widespread calcium only when they moved together to a cluster.  My cluster was also small, almost hard to counts the dots, not many I would say but enough to end up being cancer.  Get the biopsy and stay postive they do say the statistics are in your favor.  If it turns out to be nothing you will be happy, if not then you will join our club and ask a ton of questions.  Many of us are going thru the same things right now, I was a July 2006 diagnosis.

[ziggy123]

Thank you for your responses. Here I sit waiting for the phone to ring, to find out when my biopsy is scheduled. Asking for it to be done yesterday did not seem to work. My doctor promised to do all he could to make this happen sooner rather than later.
You are all correct, when you said that waiting is one of the hardest parts. At lease when you know something you can be more directed. This limbo makes me crazy!
I do know one thing for sure, I will become the poster child for not putting off a mammogram. My annual should have been two years ago, and I just kept putting it off. What an idiot!

[ziggy123]

One follow up question to all of you. What should I expect with the biopsy? Are you awake? My cluster is high up, if that makes a difference.

[boninclyde]

Find out what type of biopsy you'll have to have and we'll let you know. They are very gentle in either case.

[ziggy123]

Not sure of the techical name, but he said that he will numb my breast and use a needle to extract the calcifications. Because of the location he said that my shoulder might be sore. Do they do a mammogram as they perform the biopsy?

[Under Forty Pam]

It is probably a stereotactic needle biopsy then.  The process takes about 1 hour most of it is prep.  You lay on a table with your breast thru a large hole.  They squeeze you in like mammogram and it stays compressed the entire time, probably 30-40 minutes and that is the hardest part.  They numb you with a few needles that you will feel but isn't too bad.  They take many pictures along the way to line things up.  When they are lined up and ready to go they do the real procedure which is only 12 seconds (for me anyway).  Then you stay there in the same position while they check and double check to make sure they got a good sample with the calcification in it.  Then they clean you up and bandage you a little and send you home.  Have someone drive you to the appointment.  You can drive yourself but your nerves will be bundled up a bit so it is just easier.  Plan on a lot of ice packs for the ride home and the rest of that day and the next day.  My procedure was on a Fri and I felt a little tired on Sat then relatively normal on Sun and even played softball on Tue.

[boninclyde]

That doctor is working for you now. Call him and ask what kind and what to expect. Keep us posted and we will tell you what to epect. Good Luck. I do know the pain medications is very important. I had two different types performed. The first was nothing. But the second was a little more painful. They can not give me ephineprin because of a heart condition. But they certainly could have given me more of the stuff without the epi.

[ziggy123]

Good idea about getting a ride. I can be too stubborn thinking that I can do it all myself! You are right with the steroscopic term. Sounds like it is not too unbearable. I teach school, so I am hoping that everything can be out of the way before it starts.

[Avidhiker]

My radiologist initially said I would be a candidate for a sterotactic biopsy.  He even walked me to the room with the "table" in it so I can see up close what it would be all about.  He is an exceptional radiologist, Dr. Dill.  Turned out, however, he was wrong:  My breast surgeon said I needed an open biopsy because the area of concern was spread out over too large an area for a needle or stereotactic biopsy to be accurate.  He performed 7,000 breast surgeries over a 33-year period, trained at Sloan Ketering, teaches, etc.  I didn't seek a second opinion.  I trusted his opinion thoroughly and still do.  I had conscious sedation for the procedure with a local. I felt and remembered NOTHING.  The worst part was the dye injection the night before.  Since I had no palpable lump, a radiologist had to inject blue dye in the PRECISELY EXACT area to be removed.  Of course, my luck as usual, that night my breasts were killing me because I was expecting my period! You are positioned sitting up in a mammo contraption.  Luckily, for me it took only 10 minutes in that kill squeeze position.  Not pleasant at all.  My incision is on the right breast, at about 9 o'clock, way on the outside just about under my arm pit, really not that noticeable when looking straight at it. As you know, mine turned out to be malignant so he just reincised for the lumpectomy.  One incision, two procedures.  (Plus an extra incision for the sentinal node biopsy to boot!) Recovery for me was easy despite going under general--took only a narcotic that night.  The worst part was not being able to take a shower until the stitches were removed.  I had a drain for 7 days and managed to hide it from the world. I had a visiting nurse every morning.  Years ago, you would at least have had to stay overnight. Not necessary with a lumpectomy.  Anyway, now it's 3 more adjuvant chemo treatments because of the size of the tumor, 2.4 cm, and then as Johnny calls it, "the hot stuff", probably 33 sessions.  I hope to be done by my birthday, December 14 and as I have previously posted, I am going to have one hell of a celebration!  Thanks for reading my story.  I hope yours will be unlike mine.

[wendyot]

A related discussion, 3 clusters of microcalcifications was started.