When is it OK to wait versus a biopsy?

I had a mamo 2 weeks ago and was called back in for another magnification based upon the ID of microcalcifications.  Had the mag today, saw the 1st films which look like a small cluter of 5 or so.  Nurse told me that the radiologist said to come back in 6 months to see if anything has changed.

I guess my question is that if there is clear ID of microcalcification, why wait?  Why not take the sample of cells and know what's going on in there?

[Forum-M.D.-RF]

Dear renee1970:  Microcalcifications are small calcium deposits found within the breast tissue. There are different types of microcalcifications, and based on their pattern on the mammogram it gives the radiologist clues as to their cause. For instance microcalcifications that are more scattered are probably due to a benign (non-cancerous) cause, a 'cluster' of microcalcifications may increase concern that there may be an underlying tumor. A sooner follow up may be recommended to be certain there are no changes in microcalcifications that appear benign.  However, if the microcalcificantions appear suspicious, further investigation, such as a biopsy, is usually recommended.  You may wish to discuss this further with your doctor.

[Under Forty Pam]

Most women have some calcifications and do not require further biopsies.  It is up to the person reading the films to see if they think a pattern exists or a change from the last films that might send up a flag of concern.  If you are concerned about the accuracy of the readings you can have another site read your films and get a report.  I had two opinions from my biopsy and I'm sure you can do the same with mammogram films.  Good luck, be comfortable with your doctors or change them.

[renee1970]

Thank you to you both for your comments.

Is there any downside to getting the biopsy now rather than waiting the 6 months?  (Cost, inconvienence, etc. aside)

[japdip]

There would be no advantage or disadvantage as far as cost, etc are concerned BUT I personally would prefer to make an appointment with a surgeon to discuss a biopsy based on his review of your films. I think "peace of mind" would be the most important factor here. If you are comfortable with the 6 month wait then do it but if not, then pursue it further. It is your decision and yours alone .... be a squeaky wheel if you have to ... good luck.

[winggirl]

Hi Renee1970,
I had a mamo that showed microcalcifications. Two weeks later they had me come back for another mamo. They decided "finding is probably benign" had me come back in 6 months. Went back 6 months later they decide I should have sterotactic biopsy performed. Biopsy showed DCIS non invasive cancer. Had I known what I know now I would have demanded a biopsy done after the 2nd mamo instead of waiting out the 6 months. Bad call on their part. My advise: have a biopsy done now do not wait out the 6 months. I'm in the process of having a lumpectomy performed. Good luck!

[suzi-q]

Do you know your BIRAD rating?  3, 4?  find out.  3 is not suspicious 4 is suspicious and should be biopsied.  I would want a biopsy done also.....Nothing ventured but much gained if by very small chance it is something.  MAKE NOISE!!!

[renee1970]

Thank you all for your feedback.  I just talked with my doc who said that the report shows only 2 small microcalcifications with no mass.  I'm just not clear on what the wait will demonstrate.  If it's cancer, will it change over the next 6 months?  If it stays the same, does that mean there's no cancer?  

[japdip]

First of all ... if you want an answer from the Professional on this forum you'll have to post your last question again .... as a new question ... they don't monitor the comments. As for myself I would feel comfortable with the 6 month wait under the circumstances you describe. I don't believe you could call 2 microcalcifications a "cluster". I'm guessing they assigned your mammo a BIRAD 3 score. Calcifications do occur normally within breast tissue and are not an indication of Cancer in that instance. Best of Luck to you .. hope the wait doesn't cause you too much concern.

[rene99]

I have had a mammogram and ultrasound.  Ultrasound shows Benign(BI-RADS category 2 13mm cyst in right breast.  My family doctor says don't worry and have another mamogram (mammogram) in 1year.  My sister has had breast cancer.  I have had two small lumps removed 12 years ago and at the same time a larger lump aspirated.  The one now is approximately the same place as the one which was aspirated.  Should I pursue this now or wait another year. Of course, I am very worried about this