Pleomorphic Microcalcifications BIRAD 5

[CarolinOz]

I am 44 years old, pre-menopausal.  I recently had a routine mammogram.  They found "abnormalities" in my right breast and suggested compression magnifications be performed.  I had the additional views taken on Monday.  The radiology report states "a collection of 8 to 10 pleomorphic microcalcifications near the right nipple.  These are highly suspicious for malignancy.  Biopsy is necessary."  The report also states that "there is a re-demonstration of a moderate heterogeneously dense fibroglandular breast parenchymal pattern".  I have an appointment with the surgeon next Monday morning to schedule a stereotactic biopsy.  I know I've read that most microcalcifications are benign, but there is obviously some concern.  I'm sure I'm putting the cart before the horse, but what are the odds that this is DCIS vs. a more invasive tumor?  Are 8 to 10 microcalcifications a few, or a lot?  What are "parehchymal patterns"?  Also, what can I expect from the biopsy itself....recovery time, pain, etc?  

[BhumikaMD]

Hi,

BIRAD means breast imaging reporting and data system- it is used by radiologists to classify breast lesions. Further management is then decided accordingly.

Category 0: Need Additional Imaging Evaluation
Category 1: Negative
Category 2: Benign Finding
Category 3: Probably Benign Finding; Short Interval Follow-Up Suggested
Category 4: Suspicious Abnormality; Biopsy Should Be Considered
Category 5: Highly Suggestive of Malignancy; Appropriate Action Should Be Taken

Category 5 does mean highly suspicious for malignancy and for a confirmed diagnosis a biopsy would be required. Discuss the follow up plan and management with your doctor and see a breast specialist and oncologist for further treatment.

A biopsy is a very safe procedure and you could talk to your doctor in detail about this prior to th procedure. You could also take pain relief medications in case you have any symptoms of pain.

Let us know if you have any doubts and keep us posted on how you are doing.

Hope this helps.

Good luck.

[japdip]

I wouldn't say that most microcalcifications are benign exactly.Microcalcifications occur normally in breast tissue BUT when they are grouped in certain patterns they become of considerable concern. This is evidently true in your case, hence the BIRAD 5 score. No way to tell what type of cancer is involved until the biopsy is done and the sample viewed by the Pathologist. This is a journey that many of us have taken and I wish you the best. Try to stay calm and take things one step at a time.

[nanilady]

I also had the microcalcifications and my dr's have been watching them for the past year and a half. I had the same type of biopsy in January. It really isn't too bad. They will numb the area before inserting the needle. Probably the most uncomfortable part was the positioning (you lay on your stomach) and the compression of my breast (they use paddles to squeeze it to get the best angle of the spot). They are mostly skin after nursing three babies....and because of the location of one of the clusters, they had to get to the area  the long way meaning the whole length of the breast stretched out and smooshed...if that's a word! Anyway, the whole procedure of extraction only takes about 15 minutes or so, but the setting up part takes a while. After, they steri-stripped the tiny incision and then conducted another mammogram of the site. I think mostly because they insert a small chip so they know that they biopsied that site. Again, this was only a little uncomfortable. The numbing wears off in a few hours and the site will be quite tender but not unbearable. Just take some tylenol or aleve and put ice on it....I know, that doesn't sound good, but it will keep the swelling down. Also, keep a bra on. It helps to keep the breast from moving around too much. I was back at work the next day.

I have to say though that it is a bit exhausting. I drove myself there and met my husband and he didn't want me to drive home but I needed that little bit of time to myself to sort of process everything and I think I slept for quite a while but not because the procedure was too much...because thinking about everything was! My results came back that I "most likely" have fibrocystic breasts and they are going to check again in 6 months.

I was told that most are benign so just keep thinking good thoughts. I hope this helps.