classifying calcifications

[ziggy123]

I am a 55 year old, mother of five, whose mother is an almost 20 year survivor of post-menopausal BC. I recently had a mammogram that indicated a small (about 8) clumping of calcifications. These were new since my last mammogram two years ago. The radiologist recommended a biopsy and my surgeon agrees. While my surgeon said he does not think that the calcifications are worrisome, the biopsy should be done to be on the safe side. I try to focus on his "not worrisome" comment but at the same time, I am very concerned. How are calcificationc classified? What percent are BC?

[CCF-RN,MSN-rf]

Dear ziggy123:  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 and further investigation, such as a biopsy is warranted.

[Under Forty Pam]

Make sure you get a breast specialist surgeon.  The more the experience the better to make healing easier on you.  Not to scare you but I got the same info about my cluster of calcifications.  They said most likely it would be nothing, unfortunately it was cancer.  Statistically things are in your favor.  Keep us posted, I spent all of July going thru what you are beginning.  Good luck, we hope you don't join the club.

[ziggy123]

I read all of your comments from every listing on this site and I found your words very comforting and reassuring. I thank you for that. My surgeon is one of the top breast specialists in my areas so I feel very lucky about that. I do not know if we are s upposed to use this forum to exchange question but, were your calcifications clustered?

[Avidhiker]

I agree with Pam--get to a breast specialist.
I had an abnormal mammo too.  The radiologist rated it a BRAD4; I had an open biopsy and unfortunately my microclassification cluster was cancer.  Micro and opposed to Macro are more suspicious.  Statistically, my surgeon told me that 15% of the time it will be cancer.  I had the bad luck.  Hope yours turns out OK.  Although this "club" has terrific members, I hope you are not inducted into it.

[boninclyde]

We talk about lots of things here. If you have a questions we'll try to answer. My calcifications were both clustered (2) and wide spread.

[ziggy123]

I have one cluster with 8 small calcifications, with no lumps or masses. Did anyone have a lump assocaited with their calcifications? This is high up on my right breast, the same breast that I had calcifications how up on many years ago. According to my doctor, took "took care of themselves." Last time he had me follow up at six month intervals. This time he said I could do that, but he would rather I have the biopsy. I think that I am reading too much into his comments rather than focusing on his not wanting to take any chances with me. Last night I cried and cried and cried some more. Please forgive me for being such a baby, when I do not even know anything at this point. Please know that I will keep all of you in my prayers and I apprecaite you concern in return.

[Avidhiker]

No palatable lump to me, my boyfriend, my OB/GYN, or my breast surgeon.  My breast surgeon did say that he did feel a little "thickening, so something must be going on" (not necessarily cancer, but it my case, it was).

[boninclyde]

I had a tiny beebee on my right breast just beside my nipple about 7:00. My calcifications run from my nipple toward my under arm. I am no doctor but I don't think calcifications "take care of themselves". I believe I am the biggest baby here. I have cried for almost 4 weeks now. It's OK to cry.

[Avidhiker]

No way, I am the biggest cry baby!  I had a short melt down last night and you know what, it felt good.  It is OK to cry. Darn it, we will get through this.

[Under Forty Pam]

Yes mine was a cluster of microcalcifications.  Not very many, the cancer site was only 5mm in total which is small but none the less no matter what size the process is the same, long and time consuming.  We all hope you don't join the "club" either.  I am not much of an emotional person but I have to admit when the doc called to tell me I had cancer I did cry the entire ride home from work and most of that night.  I don't cry much I just lose sleep instead.  I've spent many nights waking up at 2am.  I spend most of my time coming up with ways to convince the docs to move appointments up to get them over with.  I must be the only person to demand surgery as fast as possible.

[ziggy123]

I am embarrased to admit this, but my surgeon is godfather to my oldest child. But we do not see each other socially and really only talk when I have an appointment. When I called his office and his receptionist kind of put me off, I took matters into my own hands and called his home! Despite my familiarity with him, and I know that he will do anything and everything to take take of me, I just keep waiting for the other shoe to drop. I am also not a crier, but everytime one of my kids calls I get emotional. How did you tell your family. How many people did you tell? No husband (well an ex, but enough said about that!), but I do have a great friend (she knows, but she lives 4 hours away). My three youngest know because they were home. Two oldest, not yet. I do no want to tell my mother...she is an anxiety ridden 84 year old. I figure I can tell her when I know something for sure. I feel as though I have adopted all of you as my surrogate family!

[Avidhiker]

My live in boyfriend of 12 years is going through it all with me.  He is truly my soul mate husband even though we don't have that marriage certificate.  HE IS MY ROCK.  I have no children.  I have an older sister with whom I am not close with.  Since we are 9 years apart, we really have nothing in common except for our 92 year old mother, who is self-sufficient, healthy and sharp! I didn't tell her until after I had my biopsy and then I only skirted the issue ("Mom, remember when you had your calcifications?  Well I just had some removed because they don't like to let you keep them in anymore, blah, blah......").  She knows everything now, is taking it pretty well and has become a member of my support group, along with EVERYONE in my office (talk about a surrogate family!).  As far as my neighbors and beach buddies are concerned:  No way.  By the time the news would make the rounds, it would be totally inaccurate and seriously bleaker than ever. (Remember Peyton Place?  Oh yeah.)

[ziggy123]

Thanks for your response. The way you describe neighbors and such is how I feel about my co-workers. I do not want to become the topic of conversation at the lunch table or have people look at me with the "sad eyes." I hope that I am putting the cart before the horse here as I have yet to even have the biopsy! I am just glad to have your comments to ease my fears!

[Under Forty Pam]

I only told my immediate family thru the biopsy phase, didn't even tell my boss why I needed a vacation day out of the blue.  After I got the results I told everyone.  Many people at my work know, both softball teams know, most of which are men and they are supportive too.  You need some support depending on the outcome.  My husband is great, he has been with me to every appointment.  You might consider bringing someone with to key appointments to help remember or ask questions, it is a lot of info to listen to.

[Under Forty Pam]

When is your biopsy scheduled?  Don't get too worked up until you have test results to work with.  I know easier said than done.

[ziggy123]

I have not heard from the surgeon as to when it will be. I had to have my son drive over my insurance info yesterday. No one will do anything until all of the insurance info is in place!
I am hoping that the biopsy will be early next week. But I cannot remember from my conversation with my doctor if he said that he wants to see me first or he will just schedule it. Too upset yesterday to remember half of what was said to me or what to ask. I should call his office, right? From what I have read it takes a few days to find out the results, correct? Dragging this out is torture, but I am not telling you all anyting that you don't already know.
I was reading some postings on a dite sponsored by Johns Hpkins in Baltimore and their turn around time for biopsy results is 24 hours. Why can they do that and others cannot?!?

[boninclyde]

Oh yes they have to make sure they are gonna get paid. My second biopsy did have results turned around in 24 hours per my doctors request. It can be done. I think some doctors or maybe some cases are more of a medical emergency. Yes most definately call his office and ask more questions and ask what type of biopsy. They sould not mind.

[Montana girl 06]

My post is in response to this thread and to a thread that was closed today because it reached its limit of responses. I am part of that 85% of benign microcalcifications. I have had two biopsies for worrisome clusters (in several locations) and both were benign. I've been advised to have a 3rd biopsy for calcifications (birad 4) in a new area (only 6 months after my last stereotactic) but instead I took the surgeons alternate recommendation of returning in 3 months for another mammogram. It's difficult to wait, but I can't put myself through a biopsy every 6 months. As a result I seem to be obsessed with getting as much info as I can on BC. I keep wondering if I have cancer somewhere in my breast and they just can't find it. I have lots of lumps in addition, but they don't think they're associated with my calcifications. Ziggy, what is your birad? Thanks for your offer of prayers. I will do the same.

[ziggy123]

I do not know, because as I said I kind of stop listening after I heard the word biopsy. I have a call into my surgeon and have a list of questions for him. I am glad to hear that yours were fine...it gives me great comfort. According to my surgeon, the chance of something being wrong, is 8%. As my son pointed out...that means 92% are fine.This is a lot lower than any of the other numbers that I have read about. But anyway, he does not want to take a chance with it being only 8%. You refer to your as being part of 85%. I hope that I heard the number correctly. Were yours in a cluster? Do you know how many were in the cluster. Were your other biopsies for birad 4s? I too have lots of lumps. They did an ultrasound, but said it was fine..everything appeared to be cysts.

[Montana girl 06]

I don't know what birad my other calcifications were.  With both of my other biopsies I went through the same routine, biopsy was recommended by both radiologist and surgeon. With my last biopsy the radiologist met with me and called the new calcifications "worrisome." So, I'm guessing they were probably birad 4. I don't know how many calcifications there are, only that I have several new areas of small, pleomorphic, clustered calcifications. The ultrasound indicated several cysts, and 3 hypoechoic lesions with slightly ill-defined margins, possibly fibroadenomas. I got the radiologists report after my appointment with the surgeon so I wasn't able to ask if I should be worried about the other lesions. I go back in two months, so I'm just trying not to worry in the meantime.

[ziggy123]

I can understand your worry. I do not know what I would do. While you want to know, at the same thime you are terrified of what it might be. It is a bit like Russian Roulette.
The first time I had a report of clacifications (about 8 years ago), my surgeon said to wait six months and then check it out again. When I went back, all was well. This time he is recommending the biopsy, so I am on the edge. I have my appointment with him on Tuesday, just to go over the report and to set up the procedure. It seem slike that day is years away. I am not good at waiting for anything, let alone something like this. I went to the beach yesterday and had planned on staying the weekend. I ended up coming home last night. Right now, my home is the only place I want to be.

[Montana girl 06]

Yes, waiting is really hard. I don't think other people understand just how hard it is. When is your appointment with your surgeon, and when is your biopsy?

[ziggy123]

My appointment is Tuesday, August 15th with the surgeon. They do not schedule the biopsy until you are seen by the surgeon, so again...you wait. I hope that he will get me in before the end of the week for the biopsy. I have not been eating, so while I have dropped a few pounds, it is for the wrong reasons.
In the meantime, I am trying to keep busy around the house, painting trim, directing my kids with room cleanings, idiot stuff, but it keeps my mind busy.
Are you definite about not doing the next biopsy? I talked to my daughter this morning, who told me about her friend's aunt who has had 8 biopsies (all negative) done!!! My nerves would never stand up to the strain!
I am waiting for a response to my classification of clacification questions. They must not respond on the weekend.
Please know that you and everyone on this site are in my thoughts and prayers.

[Montana girl 06]

I am only postponing a biopsy most likely. And I'm on pins and needles as a result. I read somewhere on this forum about someone who was told they could wait for  6 months with their calcifications, and in 6 months there was no longer a problem. I also read about someone who had 7 benign biopsies and number 8 was cancerous. I will probably have the biopsy in October if my surgeon recommends it. Here is the birad info I got from my radiologist. 0-incomplete. Needs additional evaluation. 1-negative  2-benign 3-probably benign 4-suspicious 5-higly suggestive of malignancy. I don't have statistics, however. Hope that helps. Thanks again for the prayers.

[Montana girl 06]

Just a clarification on my last post. I assume the birad classification I listed is used by radiologists for a variety of lumps and calcifications. I don't know if they classify calcifications alone.

[ziggy123]

The first calcifications that I had "took care of themselves" according to my surgeon. I am not sure what that means but this was after they had remained unchanged for several mammograms. I need to   listen very carefully at my Tuesday visit. I did not hear half of what my doctor said to me on the phone when he called to say I should have a biopsy.
I got my report in the mail from the diagnostic center, that reported that my mammogram "showed an area of abnormality that requires further follow-up by your physician." Pretty vague, huh? No mention of calcifications. I do know that my ultrasound was clear, but then again, calcifications do not show up on an unltrasound, right? If I had any lump associated with this, would they have shown up?

[boninclyde]

Ziggy I did not have a lump or mass either yet I have breast cancer. However some or alot of calcifications are not cancer. I have read that an injury can also cause calcifications.

[ziggy123]

How many calcifications did you have? Were you told the size or the Birad?

[boninclyde]

The whole right side of my right breast was quite a bit of calcification but there were two clusters (circles) with approximately 25 clacifications in them. I also had what looked like a duct 1/4" long of dead cells possibly.

[Montana girl 06]

I'm hoping there will be no change in my calcifications during this three month wait so I don't need a biopsy. I went for my annual physical today and my doctor spent a lot of time discussing all this with me. She got a report from my surgeon supporting my decision to wait on the biopsy as long as I follow up in 2 months. That in addition to my just having a biopsy in Jan. made her supportive of my decision to wait. She also said she would contact a breast specialist if I'm uncomfortable with my 3 month results. I feel better about my decision. I wouldn't mind collectiing info on breast specialists in Seattle, Minneapolis, or at Mayo (Rochester) since I have family in those places. Anyone have recommendations? No breast specialists here in Montana! Let us know how your appointment turns our tomorrow, Ziggy. My prayers are with you.

[displaced Texan]

Hello all!  I've been reading all your comments for several hours (and doing research).  It's funny how going through this same terrible ordeal instantly bonds total strangers!  I've had 3 mammograms in the last week, found microcalcification cluster and had my stereotactic biopsy today.  Now, I just have to play the waiting game. Fortunately, I get to find out tomorrow (Aug. 15th).  I will agree with y'all that waiting is the hardest part.  Although, my biopsy was painful.  They gave me the numbing shot, but I could still feel it!  Followed by 2 more numbing shots!!  Then it was just unpleasant.  They said it was probably from having fibrocystic breasts (the medicine didn't disperse evenly).  Has anyone experienced that?  I completely understand the worrying.  In the last year and a half, I lost my only sister to breast cancer and my Mom to cervical cancer.  Months before my Mom died - they biopsied a lump in her breast and found it to be precancerous. Since she had cervical cancer, they decided to play it safe and give her a mastectomy.  So, I've been afraid of getting it myself.  Then I have my routine mammogram - and here I am in shock.  Lots of prayer gets me through!

[Under Forty Pam]

Hang in there and take the news one day at a time.  If it turns out good news you can be back to your normal life in no time.  If you join the club we will help you thru it.  Takes notes, jot down questions to ask the docs in the middle of the night as you think of them.  Research and reading are your best weapons to choose what options are right for you.  Depending on the news get a real good breast surgeon, recovery is better that way.  I actually thought the lumpectomy was easier than the biopsy, more experienced surgeon I think.  I am only 1 month ahead of you and already feel a lot better to know the cancer is out and I am working on prevention now.

[ziggy123]

Hello to all-
I just came from my appointment w/the surgeon. There was a mix-up with the appointment, when I called frantic last week they tought I was coming in then and cancelled today's time. I had to wait around for them to fit me in. My mind immediately went to...oh no this is a bad sign. Just like the other day when I went to the beach to relax only to get a phone call from the Breast Cancer Coalition asking for a donatin because they were sure, "that I understood the importance of early detection!" I thought...is ths a cruel joke? How do you know about me?
Anyway, you are all so right about finding the best breast doctor/surgeon available! My Dr. has put me in a much better frame of mind, by going over the radiologist report with me, giving me a thorough physical exam, and going over every xray and pointing out all of the areas of concern and why he is not concerned with other areas. I have two groups of indeterminate calcifications that are microscopic, teeny tiny. One is in front of another and the deeper one is the one they are going after, because they cannot tell anything from the xrays. He told me that should it turn out to be BC it is so early and so small, it would be okay. No one wants to think that it will show BC, but just knowing that it is not the size of my head makes me okay.I feel so much better about everything (except for the two moles that he wants to biopsy at the same time!!!). My biopsy is scheduled for 12:30 tomorrow and I should have three of the five path reports by Friday. Please keep me in your thoughts and prayers as I keep all of you.

[Under Forty Pam]

Wow, fast turnaround for scheduling the biopsy.  Those test results do come pretty fast. Remember 4 of 5 turn out to be nothing.  Remember you are on this site to research and it is primarily made up of the 1 of 5 people that weren't as lucky.  The odds are still on your side.  When you find out you are in the 4 of 5 don't forget about us 1 of 5 folks.  Let us know the test results.  Good luck and ice packs will be your friend for 24-48 hrs!!!!!

[ziggy123]

Thank you all for your good wishes.I just wanted to let everyone know how lucky I am to have an understanding, caring physician who will take the time to ease my fears and answer all of my questions. He has given me peace of mind in the face of a very scary situation. I am very grateful to him for that. I pray all of you have the same fortune with your doctors.

[boninclyde]

Do you know what type of biopsy? I had two and they are not to bad. The pain meds are you answer. And yes the ice packs afterward will be of great help. They will give you these. Wear a button up shirt (very important). See if you can find out what kind. Not to scare you but some test/needles actually pushes away the area they want to biopsy. It is really hard to keep that tissue in place. That is why I had to have a 2nd. Results will probaly take 3/4 days.

[ziggy123]

I am having a core needle biopsy. My doctor said that my primary area of discomfort will probably be my shoulder since I need to have it over my head. Anyone else have their procedure done in this position. What kind of bra works best for after you are done?

[boninclyde]

If you have a bra that is a little big that would be good. You need room for ice packs. Remember the button up. My 1st biopsy was core needle like this. Absolutely no pain. They took 4 different samples going in and out of breast each time same whole. Tell them to tell you every step they take. If they are good they should do this. I did not even no the needle was in. However when the sample is taken there was some noise when the needle was punched into sample they need to get. No pain just noise.

[ziggy123]

Boy, am I stupid. I went and looked up the core needle and that is not what my Dr. described. I think it is called a Mammotome breast biopsy (also called vacuum-assisted biopsy)and I am basing this on my doctor's decription of the process. He said I will be lying face-down on a table. And here, I thought that I was paying so much attention. He did say that a clip willbe inserted to mark the spot of the biopsy. Does the success of the biopsy rest on getting all of the pieces? If they miss some, do they keep trying or do you have to cme back? Sorry for all of the questions.

[Montana girl 06]

displaced Texan - You are in my prayers. Let us know the results.

ziggy - In Jan. I had a stereotactic biopsy (also called Mammotome - I think some of the stereotactic machines are called Mammotomes, thus the name). They take tiny slivers of tissue. You're right, they don't get all of it. But they can take a number of samples. I asked my radiologist if he felt he got a good selection and he said he did. My surgeon told me stereotactic biopsies are about 97% accurate. I was extremely stiff and my arm was totally asleep after the biopsy. I thought that was the worst part. They make such a tiny incision (nick) and mine healed quickly.

[boninclyde]

I think they just want a sample now. If it is nothing they will probaly just watch it. If it is still suspisious they will do other surgery. This was the second test I had done. They lie you flat (don't move) They will miss there sample. It is guided by mamo/ultrasound. The noises is scary. There again the pain medications is very important. I have MVP and they do not give me shots with epinephrine (they should have given me more without the epi they only gave me 2 small injections) so i am sorry to say mine hurt very bad. Worst pain I have ever felt. Just tell them you want plenty of meds. I am sure others here have had the same test and it did not hurt them. Sorry maybe I should not have shared my experience but my situation was very different. Ask as many questions as you like.