calcification and mammogram

[Taimse]

I recently viewed my mammogram films. I'd had a very painful stereotactic biopsy a year ago and had seen mammogram films for the first time at the surgeons. Biopsy neg for cancer.  Fibrocystic breasts.  Schlerosing adenosis.

In my left breast is clip where biopsy( upper outer quadrant left breast) was and then a white dot which radiologist had written to doctor to say it was a microcalcification but unchanged from previous films.    I never knew I had a calcification...located in middle of breast on film, but probably behind nipple?
I have never been told I had this...I don't remember seeing it on films last year, but it could have been there as I was concerned about what surgeon was showing me.
Why have I never been told about this?  Only thing I ever get in mail from radiologist or even the doctor has been something like no suspicious findings and to keep doing breast exams.  That is pretty much what radiologist said this year....nothing to suggest cancer.  They use a computer to help with reading the mammogram films in addition to radiologist's scrutiny. He wrote to my doctor though to say that due to my breasts being dense, they might have missed something. Said microcalcification in left breast was unchanged.
I have never been told before, that my breasts are dense.  Last year's note, doctor showed me, recommending biopsy, said nothing about dense breasts.  I have lost 20 pounds since last year. Am at about 21 percent body fat.  My breasts are about half the size they used to be. I am 51.

[troyryans]

Taimse,

I have been told for many years that my breasts were dense, and have undergone a needle biopsy and surgery in 1994 for what turned out to be a benign lump. Late last year I underwent two stereotactic core biopsies after tiny calcifications were found during my annual mammogram. I had random calcifications in my left breast, and what appeared to be clusters of calcifications in my right (where the two biopsies were taken). In the instance of the right, it turned out that I had atypical ductal hyperplasia which can be a sign of trouble. I immediately had surgery to remove the calicifications and surrounding area which confirmed the biopsy diagnosis.

Because atypical hyperplasia does not cause lumps and they can't be felt during monthly self-exams, they may or may not be detected during a normal mammogram. In my instance a very sharp radiologist picked up the abnormal shapes. The diagnosis of ADH now puts me into a higher risk and I am screened more frequently (every six months) so that if a cancer does develop, it is being caught in the early stages. That combined with my family history raised the stakes a bit, and I am now on Tamoxifen for the 5-year regimen. I have also undergone genetic testing (negative) and have six month meetings with an oncologist.

At this point the left breast random "non-suspicious" calcifications are being followed very closely (have another mammogram on Monday to see if any change), although the "wait and see" attitude can be frustrating.

I learned after the first breast surgery I had to always ask for the radiologist and pathology reports for my personal records. Even though I need a medical dictionary to read most of it, I have found interesting information that always opens up further conversation with the doctors. Knowledge is power!

Continue to ask questions of your doctors, and make sure that your screening appointments are kept. A second opinion of your previous findings might also be helpful, particularily since you were not told the whole story the last time.

I wish you good luck and hope always for "negative" news in your future!

Kathy

[CCF-RN,MSN-JS]

Dear Taimse, 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 single microcalcification would not necessarily be of concern.
Normal breast tissue is very dense.  As we grow older the amount of breast tissue decreases, and the amount of fat in the breast increases.  On a mammogram denser areas of breast tissue show up as white on a mammogram, and fat which is not very dense, shows up as gray.  Having recently lost weight and likely fat in the breasts, the mammogram would likely show this difference.