Stereotactic Biopsy for Microcalcifications

I had an annual screeing mammogram which showed a cluster of microcalcifications in the anterior left breast 3 o'clock position, which are increased.  I returned for cone magnification views.  The report, which I obtained a couple of days after the second mammogram, refers to findings of a cluster of microcalcifications in the lower inner quadrant of the left breast, middle depth, which demonstrate heterogeneity and pleomorphism.  The diagnostic category is 4 -- suspicious.  The mammography center converted to digital shortly after my mammogram a year ago, and my breasts are dense, so it is difficult to compare previous films to these.  The radiologist volunteered that the odds of this being malignant are 10% to 50%.  I am in my early 60s.  The two reports appear to me to refer to different quadrants of the breast -- 3 o'clock vs the lower inner quadrant.  Am I wrong, or could the two different radiologists be looking at two different areas of concern?  Should I call the office and ask about this?  If there is some discrepancy, and there are two suspicious areas, I certainly would want that taken into consideration at the time of biopsy.  Thank you for any help.  Linda

[BhumikaMD]

Hi,

You could reconsult with your breast specialsit and get a repeat mammogram before the biopsy procedure especially ocussing both the areas in the reports.

A BIRADS 4 would mean that malignancy would need to be rule dout and therefore a biopsy needs to be done.

Let us know what your breats specialist advises and post us if you have any other doubts.

Keep us updated on how you are doing.

Regards.

[Linda444]

Thank you so much for your response and advice.  I do not have a breast specialist yet.  This problem was discovered during a routine mammogram, and the second mammogram and stereotactic biopsy have been scheduled with the radiologist.  I left a message last night for one of the radiologists to call me.  I just called again and told the receptionist of my concern that there is a discrepancy between the two reports, and that I am concerned that there needs to be a second cone magnification of the second area.  I did not want to wait until the biopsy and find that it would be delayed because of this.  She said the radiologist would call sometime, and that she thought they would do a mammogram just prior to the biopsy if necessary.  Since she couldn't help me with the clock positions, I don't think she's a source of information, but I will wait for a call.  Thank you again!  Linda

[Linda444]

I just received a call from the radiologist who will be performing my biopsy.  He said that the first radiologist just misspoke about the clock position.  He had looked at my mammogram again and confirmed that there is only one area of concern, not two.  I am satisfied with his assessment.  Linda

[MalindaCarolyn]

I got my ultrasound guided biopsy yesterday and because I was confused over what the oncologist ordered and what the two internists who had palpated my breast had told me, she was nice enough to reultrasound the areas and do a manual exam as well. She told me that she could feel a riedge near the nodule that they were biopsying.

You should feel comfortable telling your lab (doing the biopsy) about your fears. They can help make them go away.

She said she would call me as soon as the results passed her desk tomorrow.

As long as I breathed with the incisions and didn't clinch up, the biopsy wasn't painful. My mind had run the gamut of what it would be like... but the size of the needles that they (in my little mind) would have used wouldn't have fit into my little breast. It's funny what the unknown can look like in your mind.

I am hoping for the best.

I wish you the best too.

[Linda444]

MalindaCarolyn, thank you so much for your supportive message.  I see that we're from the same state.  I will remember your advice on Friday when I have my biopsy, which will be mammogram-guided, rather than ultrasound.  I did talk to the radiologist this morning because of the confusion (theirs, not mine!) about the location of my calcifications.  We're on the same page now.  I will be thinking of you, hoping that everything turns out great for you.  Hope you get this message.  I've never used a forum before...