nipple discharge and cluster of microcalcifications

[foreigngirl1]

I am 41 years old with no family history of breast cancer. I had a normal screening mammogram in September of 2008 (4 months ago).

2 weeks ago I noticed bloody discharge from 2 ducts (close to each other) on my right breast. The discharge was not spontaneous, I squized the nipple during my monthly self breast exam. I went to the breast specialist and they did an ultrasound (normal), Aurora breast MRI (normal) and mammogram. Mammogram showed a small cluster of microcalficiations not in the same place where the bleeding ducts were but in the same breast.  The radiologist could not clearly explain to me whether these calcifications were on my September mammogram, whether they were missed or whether they were new. She said thee were undeterminate (score 4) and recommended a stereopatic biopsy that I had done yesterday (results within a week or so, long wait..) She said it’s 50/50 chance of good/bad outcome.

I also I had my ductogram yesterday and the radiologist told me what she found a bunch of stuff there (the word she used was “debris”)

She said is indeterminate – if it’s a pappiloma, it’s a bunch of them… or something else (scary stuff). Now I am referred to a surgeon to do a surgery to remove the duct (under general anesthesia) and take a biopsy of it. She did say again 50/50 chance of good/bad.

The more procedures are done the more I am freaking out…..

Any word of wisdom/encouragement for me? Could it be cancer even if MRI was absolutely normal (not enhancement, etc.) What is the percentage of benign outcome in this situation? My radiologist is supposed to be top notch but not very sympathetic. If it’s not benign can it be invasive and not DCIS with the normal MRI?

The waiting period is stressing me out to the point where I can not eat.

Thank you very much for your attention to my questions.

With great appreciation

Foreigngirl1

[Cleveland Clinic]

Dear Foreigngirl1:  Without evaluation, including review of all scans, ductogram, and doing a clinical breast examination, it is impossible for us to speculate on what this might be.  Each test provides small bits of information that may increase or decrease suspicion but the bottom line is that the only way to be absolutely certain in a situation where there may be mixed information, is to do a biopsy.  As this has been done, you will soon have your answer.  Try to focus on activities that might distract you until you get the results.

[Jaquta]

Hi
I would probably advise you to take everything one step at a time and not get too far ahead of yourself or the process.
Waiting for results can be extremely stressful.  I think it helps if we keep active and try not to ruminate on all the potential negative outcomes.

Most bloody nipple discharge is said to be benign.

My understanding is that an increased number of papilloma represent an increased risk for breast cancer.

Try not to stress about all the tests.  The number of tests don't correlate with the severity of the outcome.

I'm not sure of the significance, or otherwise, of the MRI findings so I'm not going to comment on that.

DCIS is graded too.  I think high grade DCIS can be invasive too.  Or at least it can become if it is not treated.

You may find out more after you get your results from your biopsy back, but if not, you will after you have surgery.

The radiologist sounds non-committal.  It must be a difficult position for her to be in.  I expect she would have a feeling based on all her experience but she can't make a determination based on the information she does have.  Not conclusively anyhow.

I don't know if this was helpful.  I just wanted to help you feel less alone and more supported in the process.

Just remember: focus on getting through one thing at a time.

Good luck for your surgery.  I hope it all goes well.

J