microcalcifications

[FJW]

Does anyone know how long one should continue to have an increased number on microcalcs before it is considered abnormal.  Mine have increased in number and in pattern. I have a long history with them and cysts (both solid and fluid filled), along with a past history of bloody nipple discharge, which is currently just dark green in nature.  Also, I have had dilted ducts for as long as I can remember. I have had needle asp, wedge biopsy, smears, MRI's spot magnigfication, ultrasounds, etc. and am always told to come back in 3 months.  I was just wondering at what point I should start to worry about the reccomendations being made?  There is a distant family hx of BC.

[FJW]

Sorry to keep asking questions, but here goes.   What test would define whether dilated ducts are from cancer?  Is it a ductogram?  If so, when should a doctor decide to do this?  I have had many mammos and ultrasounds done that show dilated ducts, but I still haven't been asked to have a ductogram.  Just curious as to whether I should push for a more difinitive test.  Thanks again for your time.  I appreciate your advice.
~regards~

[PaulMD]

MRI's are mostly accurate for detection of breast lesions but it cannot tell if it is DCIS or cancer.  Fibrocystic breast changes can have concomitant dilated ducts but what is important is to prove that the dilated ducts do not harbor cancer.

[FJW]

Thanks for the reassurance.  I am scheduled for a digital Mammogram, and ultrasound on June 6th.  Hopefully the new lump I have will be nothing again, and I can go back to every three month screenings.  Do you happen to know if MRI's are always accurate, and can they have false negatives as far as screening for DCIS?   Also, are the dilated ducts something that occurs with fibrocystic breasts, or is that another issue altogether?  I really appreiciate your site.  Thanks again.

[PaulMD]

Hi there.

I understand your worries.  The microcalcifications can both point out to a possible malignancy based on patterns identified by the radiologist.  An increase in microcalcifications also does not necessarily mean that there is a malignant process going on.  The biopsies are employed to ascertain the nature of these findings.  The negative biopsies that you had were all reassuring, however the close follow ups that your doctors are recommending are precautions that they are taking to monitor the breast changes.  I believe that once the microcalcifications stabilize (neither increase nor decrease in size), or disappears, they may recommend a longer interval follow up.

Regards and God bless.