What questions should I be asking?

I had my baseline Mammogram in January 2006 the Dr. said I had clusters of Micoclaifations and had two more mammograms that year.  I've been getting regular mammograms with the same results more clusters every year since I still have concerns.  I thought I felt a small lump but after seeing my DR. he said they were cyst to stop drinking cafeine.  Now in the same breast I have another cmall lump that can be felt everytime I do a breast exam.  My gyn dr. seems to think its fine but I'm unsure.  What are the cyst?  What questions should I be asking?  Thanks

[PaulMD]

Hi there.

First of all, the previous mammograms should have been stated in terms of the BIRADS category.  This is a standard classification for radiologist, and this would tell the doctor if the calcifications or other mammogram findings are benign or needs further evaluation or biopsy.  I believe you should ask the radiologist about this.

From there, a biopsy may be warranted depending on the appearance of the lesions, may that be cysts or calcifications.

The BIRADS category are as follows:

0 - Incomplete - Additional tests are necessary to further evaluate the findings, or follow up may be needed

1 - Negative - No imaging findings; recommends routine screening

2 - Benign - There are mammogram findings, but benign in nature; still recommends routine screening

3 - Probably Benign - Breast mammogram findings are most likely benign (>90%), short term follow up test is necessary

4 - Suspicious - Breast findings have probability of a malignant nature, biopsy is recommended.

5 - Highly Suspicious of Cancer - The breast findings have a very high chance of being malignant (>90%). Biopsy or more definitive treatment is recommended.

Regards and God bless.