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breast calcifications

i just had a mammo, and needed to have a 2nd picture of my left breast as it indicated cacifications.  i was told "everything is fine; but come back in 6 months to make sure there are no changes".  at first i was relieved there was nothing immediate to worry about.  but since the test, and learning more about calcifications, i'm starting to worry about what all this means.  there is no hx of breast cancer in my mother's family so i never really thought much of it.  now i learn calcifications can become cancerous.  Scarry!!.  what are the differences being looked for to determine "everything is fine, but come back in 6 months".  i'm turning 40 this month and in generally good health.  i also was informed by a friend in the medical profession that calcifications can produce as a result of long term contraceptive usage.  is this true? can this be resolved by not taking the pill any longer?? and can calcifications cause tinges of breast discomfort/dull aches?  i'm lost and confused. and very scared.  should i trust the 6 month wait?
Best Answer
587083 tn?1327120262
Hi.
Radiologists are able to identify typically benign breast calcifications depending on their form and pattern.Calcifications are not cancer and they are quite normal in breast tissue. However, when they are growing in a cluster (grouped) they become suspicious because they sometimes cluster around a mass. If no suspicion is detected a biopsy is not required to prevent unnecessary procedures and to reduce patient anxiety.
The report on your mammogram could be a Category 3,"probably benign finding" to have suggested a short-interval follow-up.( check your report or call the radiologist to find out about your BIRADS score)
BIRADS score 3 is used when a noted finding has a very high probability of being benign.The finding is not expected to change over the follow-up interval, but the radiologist prefers to establish its stability over time.
The BIRADS score,go from 0 to 5 and this terminology is used by radiologists to describe mammography findings.
                            ----------------------------------------------
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.
                                -------------------------------------------
I really wouldn't worry so much if I were you because what your radiologist has recommended is standard procedure.If the suspicion about these calcifications were more elevated,a biopsy would have certainly been ordered.
Keep in mind that many biopsies done even on suspicious clustered calcifications are found to be benign nature.
The birth control pill affects your hormone levels, which can cause lumps thus increasing your risk of breast cancer, but I don't believe that it causes calcification.Talk to your doctor regarding the birth control pills.I would use something else if I were you.
If you  feel uncomfortable waiting six months for a follow up,you could always have your films read by another radiologist for a second opinion.
Best wishes...
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Avatar universal
Thank you much for your well wishes and info.  i'm looking forward to my trip and will do the best to focus on special times w/ my family (rather than all of this latest news).  thanks again.  take care...
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684030 tn?1415612323
Try to relax... enjoy your trip... I think that you're going to be just fine... take care, "i"
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Avatar universal
I turned 40 in September and as part of my "birthday" gift to myself I went for my yearly physical which this year included mammogram. Was called back for spot magnification views which resulted in Birads 4B-intermediate concern. Went for stereotactic mammotone biopsy and turned out to be B9 fibrocystic changes. I had no lumps or pain in either breast. Worst part of whole scenario is waiting and worrying. Hope everything turns out good for you as well. 80% of microcalcifications turn out to be B9!
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587083 tn?1327120262
Hi again,
Well, a BIRADS score 0 just means that your mammogram or ultrasound didn't give the radiologist enough information to make a clear diagnosis and usually a follow-up imaging is necessary.You said that you had a second mammogram (spot compression) and the radiologist told you that all was fine and to come back for a follow up in 6 months.So if the radiologist told you that everything is fine when he viewed the spot compression films,then nothing was suspicious to warrant a biopsy.
What your doctor has told you,makes a lot of sense because a biopsy would have certainly been recommended if the calcification appeared suspicious.Waiting 6 months for your next mammogram is not at all unusual as it's standard procedure.
Women who feel very anxious about the waiting,they prefer to have a biopsy simply because they are anxious and nervous by nature and not because something is necessarily wrong.
If you trust your doctor, then you really don't have to worry so much!...Just rely on her recommendation and try to relax as much as possible( search over the internet about relaxation techniques) to help you overcome stress and anxieties that can cause a lot of unwanted symptoms,like palpitations, pain etc...If you start the relaxation techniques now and do more exercises, you might be able to fully enjoy your vacation.  
I sincerely hope that you'll have a very good time! :)
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Avatar universal
well i had my dr. appt w/ my primary dr.  we reviewed the mammo and my BIRADS score was "0" which i understand to be considered incomplete/inconclusive.  i'm not sure to consider this good or bad.  my dr. said, as well as almost everyone i talk to,
and have been trying to reassure me, that if there was cause for concern, they would have recommended the byopsy asap.  also they don't toy around with this issue because of potential law suits.  
when we talked about the follow-up appt, i questioned if 3 months may be better than the 6 month wait, but the dr felt it was better to wait the 6 months.  she explained 1st of all, too many mammo's (i believe because of the radiation) would not be good for me.  then if i get the mammo too soon and there's no changes but then wait to get the mammo again at a later date, it may be too long of a wait.  and she said when a recommended time frame is given it's because that is what is considered the most appropriate for that particular issue (considering the studies/research done).  also a psychologist i know who worked w/ cancer patients for 20 some yrs, informed me that changes don't typically occur too quickly, and felt also that testing too soon would not be a benefit.  
dr. explained, as you did, that they want to watch how the calcifications cluster, that the calcifications are not cancer but rather what they may be attaching themselves to, if anything.  dr also said there was no connection to birth control use causing calcifications.  so, will have to question my friend again about that one.  perhaps i misunderstood her.  and as you know, the calcifications have nothing to do w/ the amount of calcium you take- calcium is good.  apparently they typically stay once formed and there is nothing to shrink or disolve them.  
when i went for the mammo it was a concern for possible cysts, but then this was discovered.  dr. said cysts are not harmful, tend to come and go, and are not cancerous.  nothing was noted in the mammo report about finding cysts.  
re: the breast pain, dr. agreed it could be hormornal but really could not give me a more certain explanation for it.   she felt, after having the tests, that i really shouldn't worry so much about it.  and i have been avoiding caffeine for approx a month and 1/2 now, since having some cardiac testing/concerns for palpatations- which appear to not be present, or so infrequent they cannot capture it.  the majority of people- dr's/people w/ similar experiences seem to feel it's mostly anxiety.  i have noticed on days that i feel less anxious, the breast pains/aches subside.  
i must confess i'm torn about how to feel about all this.  i feel lately, not only because of the calcifications but also the recent cardiac testing, that it's hard to focus on living a normal life.  i'm going on vacation next week and am having a hard time getting excited about it.  i need to eat low-fat/low-cholesterol foods (and should avoid alcohol- not quite so much for the cardiac issues but the breast health).  i usually eat low-fat foods but recently learned my cholesterol was a little high.  and like everyone, i like to indulge now and then.  i just feel i can't enjoy anything.  i really should exercise more regularly.  anyway- i think i'm rambling.  thanks again for the notes/info.  and please keep me posted on any other thoughts/info.  thanks for the encouraging words. and i hope you're right that this turns into nothing.  now to wait.....
Helpful - 0
587083 tn?1327120262
First of all,breast pain is not a common symptom of breast cancer.. and yes
you are right that breast pain can get worse with changes in your hormone levels or changes in the medicines you are perhaps taking. Stress can also affect breast pain.
Try to cut down on your caffeine intake(Coffee,chocolate cola) and salt .Wearing a good supportive bra can help to lessen the pain.The application of warm or cold (whichever works better for you) packs to the breast will allow the sensation of pain to decrease and to bring back a sense of well-being.
I am glad that you'll be seeing your Doctor soon.Write down all your question beforehand so that nothing is left unanswered.Also tell your doctor about all medicines you might be taking that could be causing your breast pain.
Try not to stress yourself too much...The odds are in your favor that everything might turn up to be just fine.Please let us now how things are proceeding.
Take care now.. and God Bless...
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Avatar universal
thank you again for your insight.  i will be meeting with my primary Dr later this week and will be questioning her about all of this.  i may ask to have the mammo at 3 months rather than 6.  then go from there.  i agree, being on top of things is key.
i  just don't understand the dull aches/pain in the breasts.  a friend who is in the medical profession says that stress/anxiety may be affecting these pains.  that we tense-up so much with anxiety it "could" be related to this- like a muscle tension.  and i think it was stated it could be hormornal too.  it's  distracting and plays on the anxiety with this issue.  i just recently was also dealing with a great deal of stress related to some cardiac concerns- so these last 30-some days have been wearing me down emotionally.  thank you again, so much.   and again keep me posted with any further insights.  
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684030 tn?1415612323
P.S. that "something " that's inserted in the breast. It's an tiny titanium micro clip. I have one.
And, you're correct, it serves as a marker to denote the site of the biopsy for future diagnostic referencing/ comparison. If the doctor's/ technicians didn't tell me that I have one... I wouldn't even know it's there! ... I don't feel it, and the way I view it, anything that helps doctors to help me... is a very good thing!
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684030 tn?1415612323
As for the seemingly sudden appearance of the calcifications... it was that way with me too. I've had annual mammograms since I hit 40... then, in 2005 when I was 49... clusters appeared in my right breast! The surgeon didn't have an explanation as to how or why that happened... he only had the complete confidence and the total assurance that calcifications:
... are not uncommon.
... are the exact same kind of calcification formations that one finds in Arthritis suffers.
... are rarely found to be cancerous.
... and, if in the very remote chance that they were cancerous, it would be so early stage that it would be 100% curable by virtue of surgical removal.

My recommendation to you is to go with your gut feeling and with what feels right... for you.
If you want/ need that 2nd opinion... go for it! Consider all options available to you... including a biopsy. I've had both surgical/ incisional and stereotactic/ needle. Yes, I've dealt with this calcification issue twice within a 5 year period. Both times... they with benign results. And, sure, there's a measure of pain involved... after the biopsy... temporary physical pain that I'd sooner deal with than dealing with the angst of living in a 6 month limbo.

Anyhow, the thing about the biopsy (surgical or needle) is that, while it won't answer why you have the calcifications, it offers a conclusive answer as to what the nature of the calcifications are... and, within days; not months!
And, that knowledge equals peace-of-mind!

Take care... and, please feel free to ask me anything, anytime, "i"
Helpful - 0
587083 tn?1327120262
Hi again,
You really should discuss with your doctor/radiologist all the options available to you.
When you meet with your doctor you could certainly let him know that waiting 6 months is making you very anxious and that you would prefer to have these calcifications biopsied now, or at least be rechecked in 3 months instead of 6.
In case your doctor agrees with you that a biopsy could be done at this time,I am sure that "iam1butterfly",who is very knowledgeable about breast calcification, can inform you more about her own experience and the kind of biopsy you might be having since she went through it more than once (I think) and she is really very good in explaining how it all went for her.
I sincerely hope that everything will soon be resolved to your complete satisfaction.
Take care... :)
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Avatar universal
zouzi- thank you so much for this clarification of the BIRADS score.  i've been reading this but unsure what it all meant.  and at the time of my mammo, i really didn't think of questions like this on-the-spot.  it's afterwards that you start thinking.  it helps to know the calcifications are usually benign, but for some reason i'm freaking out about the worst.  i had a mammo approx one and 1/2 yrs ago with no probs.  how can this change so quickly?  and can it change quickly even before the 6 month exam?  why wait 6 months, instead of maybe 3?? i will definitely be talking to my Dr about the birth control pill concern as well as these same questions.  
butterfly- it's interesting you mention about the age- which i will be asking about as well.  i hope that's not an indication of something negative.  then i also tell myself-'early detection is a positive thing'- i think.  and those pains- yes, you described them the same.  i am feeling them more-so in the left breast- the one with the calcifications, but i also feel them in the right breast- more faintly.  perhaps it's my nervous mind playing tricks on me.  i feel them under my armpit area, and my right inner breast area, which did not appear to be where they took the 2nd set of pics.  there seemed to be no concern for those areas.  and i also have learned there is no pain with breast cancer.  
i may consider either the 2nd opinion or the biopsy cause i am a very nervous person, and unsure if i can wait 6 months.  then again i hear the biopsy is painful and they put something in your breast?  to note for future tests of the biopsy?? (not sure of this)
while i was in the waiting room a poor girl had to schedule a biopsy- i felt so sorry for her.  that didn't help with the whole thing.  
thank you again- and if there's any further knowledge or insight please share- TY
Helpful - 0
684030 tn?1415612323
I can relate, as we all can,  to the fear factor.
In fact, that "scary" feeling was the very reason why I opted to have a biopsy rather than wait out the 6 months. Because I'm nervous by nature... plus, given my extensive family history of Cancer, including Breast Cancer... I just couldn't see myself waiting 6 months! But, that's just me! ... If you're totally okay with the wait-and-see approach... go for it! But, if you're, in any way, uneasy about the wait-and see approach, why not discuss with the doctor/ radiologist the option of having a biopsy?That would give you a definitive answer about the nature of the cals, now.

As for cals and contraceptive use... I've never heard of the linkage between the two. What I can say is that I've never, ever used oral contraceptives... yet I have calcifications!

As for those twinges of pain, I believe I might know the kind of pain that you're referring to. Occasionally, I'll feel pangs of dull achiness.. in both breasts. According to my doctor, that's likely a result of hormonal fluctuations. So, I don't think that it actually has anything to do with the calcifications.

By the way, was anything mentioned about your age (39)?
I was 49 when cals first appeared on my mammogram. And, my surgeon was very bothered by that as he felt that I was way too young to be manifesting these calcification growths. I tell you this not to alarm you... but to offer you insights when considering your decision.

Good luck with whatever way you decide to go. "i"
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