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Clustered microcalcs Birads 4
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Clustered microcalcs Birads 4

I had my annual mammo last month and was called back for more, magnified views.  Turns out I have a new cluster of microcoalcs in my right breast and a stereotactic biopsy was scheduled.  Well, because of my small breasts, they were unable to do a stereotactic biopsy.  The Dr sent me to a breast surgeon who said to do a mammo follow up in 6 mos.  This whole thing has made me very nervous and anxious.  I received copies of my reports and saw where it is a Birads4 - suspicious abnormality, heterogeneous, clustered microcalcs at 12 o'clock.  How can I wait 6 mos to see if this is cancerous?  It is driving me crazy and don't know what to do.  Also, my maternal grandmother died of breast cancer and my mother has melanoma.

Thanks a million,
Julie
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242529_tn?1292452814
Dear jpm25,  A BIRADS rating of a mammogram helps to categorize a finding in terms of how suspicious an abnormality looks, and whether further evaluation of an area is recommended.  A BIRADS  4 rating of an ultrasound or mammogram describes a suspicious looking abnormality that is not characteristic but has a reasonable probability of malignancy, and a biopsy should be considered.  In other words, based on the testing done they cannot rule out that something is cancer.  So to be on the safe side a biopsy of the suspicious area is recommended.  
Without ability to review the films, and rest of your information it is difficult to comment on the radiologists interpretation as well as the surgeons recommendations.   An option for you could be to obtain a second opinion.
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1162347_tn?1293506770
BIRADS = Breast Imaging Reporting and Data Systems

BI-RADS 4 is reserved for findings that do not have the classic appearance of malignancy but have a wide range of probability of malignancy (2 - 95%).
By subdividing Category 4 into 4A, 4B and 4C , it is encouraged that relevant probabilities for malignancy be indicated within this category so the patient and her physician can make an informed decision on the ultimate course of action.

Why are micro calcifications assigned a BIRAD4: Because they are considered suspicious. Why suspicious: Micro Calcifications are very small parts of calcium deposits, dust like, that are found in the breast tissue or gland. When those calcium deposits are spread throughout the gland then those are not clustered and the mammogram can see what is behind them. When they are clustered, meaning they have stuck together forming clusters then the mammogram can not tell what is behind them and a tumor could be hidden behind the cluster, the larger the cluster the larger the tumor may be. But this is only a suspicion, reason why a biopsy is recommended to find out if anything is hiding behind the cluster. If something is hiding behind the cluster it will link to another smaller cluster or another cluster will form reason why good breast specialists prefer to wait and see how the clusters behave.  

My case. I had a mammogram was diagnosed a BIRAD4 and a biopsy recommended. I had a biopsy when the pathology report came I was told I had a a stage 2 breast cancer and that the safe way out of it was a mastectomy. I had just come out of another cancer issue so I was very scared, nervous and lonely. I accepted the mastectomy and it was done with the dissection of 3 lymph nodes. A few days later I began having second thoughts, I never had any problems, pain, lumps or whatever on my breast why all of a sudden a mammogram diagnosed a BIRAD4? I began to ask questions to the Radiologist and the surgeon, when they had to answer they were always in a terrible rush and had to go. Then I got the pathology report which said it was a 2cm lobular carcinoma ER positive, PR and HER2 negative.    

The surgeon showed up to check me only once in 10 days i was hospitalized. I began to get very suspicious but kept quiet. Two days before I left the hospital I asked for all my documents, my pathology plates and reports, my mammograms, MRI s and the rest of garbage. They were very reluctant to give me all I had asked for, but then I was enraged and said I will not leave this hospital until I have all I have requested for, and I won't pay for the extra hospital days. So I finally got all I had asked for. While in the hospital I had spoken to my brother who is a German citizen about my suspicions, he ask a friend of his who is a Breast Surgeon and he was the one who said to ask for my pathology plates. Once out of the hospital I immediately sent all the documents and plates to Germany. About 15 days later my brother called me and asked, you did have a mastectomy and a 3 nodes dissection right? I confirmed it. He was very nervous and upset but finally said, YOU NEVER HAD BREAST CANCER, I thought I would die in that moment but only cried myself to sleep for several days. My sister in law traveled to where I live to see me, she got me checked out completely and asked me to get her in contact with a constitutional lawyer, I gave her the phone number. Now we have sued the surgeon, radiologist and pathologist in the Human Rights Court in The Hague and through the Constitutional Tribunal in this country where I live.

You see, I had a BIRAD4, BC stage 2 and the rest as mentioned. At the end they had their fun and chopped off my breast without ever having had cancer. This is a cancer cartel, it is all due to greed no matter what the patient feels or how the patient will feel for the rest of her life, they prey on women who have good insurance policies, but I have stopped the payments due them by my Private Insurance Company with a court order.

You have a family cancer history I had any on any of the two sides. If your gut feeling tell you not to trust, then don't trust and get a second, third or tenth opinion if necessary. Don't just sit and wait.

Good luck.          
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Avatar_f_tn
Thank you for all of the information - very helpful.  I had another appt. this morning - and they have decided to do an excisional biopsy.  What all is involved in this procedure?  Will I be able to go to work the next day?  Sorry to sound so ignorant on these things - but, this is all new to me!

Thank you,
Julie
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1162347_tn?1293506770
Lets get our terms clear, as far as I understand an excisional or surgical biopsy are the same thing. What may be involved in the procedure will very much depend on what will be size of the sample to be extracted. I had a third of my breast taken out for the pathology biopsy, I was put to sleep with anesthesia, woke up a few hours later and was in hospital 48 hours, it took me four more days to recover and I was not exactly painless. It is also true that when they extract a larger breast mass some surgeons accommodate the rest of the gland to avoid empty areas which don't look nice. You need to get a special bra for these situations that will help you feel less pain and to hold your breast properly. You will then need a daily cure of the scar and whatever other tissue is involved. This will go on until you get your pathology report in about five days which will determine what will follow.

Once you get your pathology report ask them to give you a copy of the report and the pathology plates and take them to some other breast surgeon for a second opinion, I wish I had done this and I would have avoided so much suffering.

You are not ignorant, these things should be told to us by the doctors but they prefer to avoid the subject.

Think on what you will do and how you will handle this issue, but for heavens sake get a second opinion before going any further in the treatment. One doctor can make a mistake but it is very difficult for two doctors to make the same mistake.

Take care and God bless you.
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