Microcalcifications

[Elise]

I had a screening mammogram done a couple of weeks ago.  I was sent to have a diagnostic one done last week.  The radiologist found an area of microcalcifications that she wants to biopsy.  Since this is a new concern (one I did not dream of having a month ago!), I have been gathering information in order to be informed when talking to my doctor.  I have some questions, though, that if anyone could answer would be most appreciated.
1.  Who should I consider my doctor?  My OB-GYN? The radiologist?  I don't even know who I should talk to!
2.  These microcalcifications are in a cluster, and in only one area.  I have learned that this is an indicator of DCIS, but I also know that microcalcifications can be caused by other things, such as aging.  My concern is that I am only 35.  What is the chance that these could be benign given my age?  I don't want sugarcoating ~ i.e. "just wait and see" ~ if anyone has actual statistics for biopsies that are performed on young women for microcalcifications.
Thank you for any help anyone can give!

[Elise]

Thank you to those of you who are responding to my questions and concerns.  I am definitely getting a biopsy, I just wanted to know some things before I see the doctor.  I just picked up the copy of the report from the radiologist after getting a diagnostic mammogram.  Here are some of the comments after my first screening mammogram:
  "...upper outer quadrant of the right breast there is a group of calcifications.  Although not quite as tightly clustered as might be typically expected for carcinoma, these calcifications are somewhat pleomorphic."  "Scattered elements of increased density consistent with fibroglandular tissue are noted bilaterally, expecially in the upper outer quadrants.  No significant asymmetry of the breast parenchymal pattern is demonstrated."  
     Now these are comments after a diagnostic mammogram:
    "...a localized grouping of microcalcifications which are in a segmental distributions.  These do not layer on the 90 degree lateral view and some of the calcifications occupy a linear configuration."  
   (I will be getting a stereotactic needle core biopsy.)  "The patient will likely require 2 separate incisions as the calcifications extend over a course of nearly 2 cm."
    Oops, I somehow sent this to be posted on accident!  Anyway, I also had mastitis the day I came home from the hospital 4 years ago after delivering my daughter. Would this infection cause the type of calcifications they are reporting?  By the way, the BI-RADS code is 4.  Any additional comments would be much appreciated!  Thanks!

[Elise]

Thank you to those of you who are responding to my questions and concerns.  I am definitely getting a biopsy, I just wanted to know some things before I see the doctor.  I did just get my report from the radiologist after getting a diagnostic mammogram.  Here are some of the comments:
    "...a localized grouping of microcalcifications which are in a segmental distributions.  These do not layer on the 90 degree lateral view and some of the calcifications occupy a linear configuration."  
I will be getting a stereotactic needle core biopsy.  "The patient will likely require 2 separate incisions as the calcifications extend over a course of nearly 2 cm."

[eamona]

Do not hesitate to get a biopsy!!  Microcalcifications were found on my mammogram in Jan.,2000.  I was told they were "nothing" and to get checked again in 6 mo.  Six months later I was told the same story.  Unfortunately, I did not know that micrcalcifications COULD mean cancer, so procrastinated for a year to get rechecked.  This past Aug,2001, the radiologist ( the 4th different one reading all these mammograms)had me look at all 3 mammos to see that the microcalcifications were DECREASING in number,which was not a good sign, but meant something was going on. He said a lot of radiologists don't know this. He said I should have had a biopsy a year ago, and then nailed the diagnosis as high grade comedonecrosis DCIS before the biopsy was even done.  If I had known that these microcalcifications could mean DCIS, I would have insisted on a biopsy a year and a half ago.  Because of the delay, the lesion was large with very small clear margins, necessitating a mastectomy instead of a lumpectomy. To me, negative biopsies are worth the inconvenience.

[skibabe]

I know how scared and confused you must be.  My doctor has seen some calcifications for two years with six month checks.  This was to be my last six month check except they found more calcifications.  Chances are since they just found them on you, they will just monitor them for a while.  I ended up going for a needle biopsy last week.  My primary physician recommended I contact a surgeon "just in case."  After a meeting with him, his nurse set me up with the radiologist for the biopsy.  The results were not what we hoped for.  Atypical cells were found so now I have to go for a surgical biopsy.  I am 43 and had my first mamo at 38.  You are smart to be asking these questions now.  Since I have been going regularly, I feel that whatever is discovered will be in the beginning stages and therefore treatable.  I hope you realize the same thing also.  Good luck and think positive thoughts.

[CCF-RN,MSN-rf]

Dear Elise:  The doctor best equipped to handle a situation such as yours would be a breast surgeon, someone who specializes in breast care.  I have been unable to find any statistics on biopsy results of microcalcifications in young women.  This is likely because many women your age have not even had a first mammogram.  So - the numbers of biopsies, much less positive results as compared with negative results is unavailable.  However, the average risk of breast cancer in caucasian women at 35 years old is 1 in 2,300.  Obviously, this figure may not exactly reflect your situation.