birad 4 microcalcifications biopsy?

[Rtist]

If anyone can help with my question I would be so grateful.  I had 2 mammograms that confirmed microcalcification clusters in my right breast at 9:00 (is that my 9:00 or his?), anyway, one surgeon told me to have another mammogram in 3 months or a biopsy.  Another surgeon who has been my family and friend's doctor for years with a great reputation told me he would do a surgical biopsy removing the calcifications and surrending tissue so as to test everything and not leave anything behind.  He said that he first inserts blue dye and then removes the dyed area.  I have not read anything like this on this forum or anywhere in the internet when I research.  Can anyone explain if this is common?  I trust this man, but want to research myself as it is my body and my decision.  Thank you so much.

[lizziecee]

Hi - I too have never heard of injecting a blue dye in order to do a surgical biopsy. When I had a 2 cm invasive ductal carcinoma 4 years ago, the radiologist injected the area with local anaesthetic(using the ultrasound scan screen)  and the core biopsy procedure was painless. 2 yrs later, I had a long ropey lump in a different area of the same breast  (turned out to be benign Mondor's disease) and the procedure was the same. I would ask your surgeon some detailed questions... is this a new procedure? why blue dye? Seems strange to me, but perhaps I am out of date. A surgical biopsy may be different to my two core biopsies. Hopefully someone else will come along with more information/experience than I have.

I would seek an opinion from a specialist breast surgeon at a major university hospital, if one is available in your area. You could try calling the Susan G. Komen Foundation and ask their opinion.  General surgeons are not usually experts in breast cancer. A biopsy is the only conclusive way to determine if cancer is present or not.

Good luck
Liz.

[txgrl01]

I never heard of blue dye for the breast biopsy.  I had an excisional breast biopsy in July.  In August, blue dye and a radioactive tracer was used for my sentinel node biopsy.  Ask the surgeon to explain more fully and ask for literature to read.  God Bless.

[Rtist]

Thank you so much for your answers.  I did some research myself and saw he is doing a wire localization procedure where they insert blue dye to identify the microcalcifications.  Again, I guess it is his way.  He is a breast surgeon who specializes in breast cancer.  He circled a part of a pamphlet he gave me that was about it.  The pamphlet is up to date with its date of publication.  I just still never heard of the blue dye.  Txgrl, I too heard of using it with the sentinel node biopsy.  I am going to have it on the 26 of October.  How are both of you doing now.  I will research with Susan G. Komen Foundation too.  Can you tell me where 9:00 is?  On my right breast is it on the outside or inside.  Thank you again.

[lizziecee]

Apologies for thinking your surgeon was a general one. I would assume 9.00 is on the outer side of the breast, horizontal with your nipple?

Thanks for asking about us. I am doing fine with bc, 5 yrly check up and mammo next Jan. Otherwise, not too good. I have Crohn's and gastro found a stricture (narrowing) in my small intestine which may be the cause of the current inflammation, diarrhea and weight loss of some 10 lbs in a month. He has ordered an MRI to determine if it has gotten worse since the endoscopy 5 months ago. Said I have to be prepared for surgery to resect the stricture as if it gets worse it will burst and cause sepsis. Must say I have found Crohn's to be more difficult to deal with than breast cancer.  I had the works: lumpectomy, total axillary removal, chemo and rads, but we seem to have beaten it at the moment. Wish there was a simple solution for Crohn's, but at the moment it is trial and error. I have been on self injected chemo (methotrexate) for some 6 yrs now, with a break for FEC chemo for bc.  

Hope your biopsy is benign - do come back and let us know how you got on and if we can help.
Liz.

Liz.

[Rtist]

I'm so sorry about your Crohns.  I know about the disease and how it causes such pain and interference in one's life.  You seem to have had your share and I'm sure outlets like this forum where you can help others is helping you cope and feel strong.  With your breast cancer, how did they find it and what were the first steps in the process of diagnosis and treatment.  What initially was seen on the mammogram.  I'm so glad you are doing well with your bc.  Lets just hope they can fix whatever is going on with your crohns and give you some peace and comfort.

[lizziecee]

Thank you for your kind words. Helping others with bc and Crohn's does bring some comfort, as when I was dx with Crohn's 37 yrs ago, hardly anyone had heard of it - including doctors.

BC - interesting you ask how it was diagnosed as it was somewhat unusual.  I went for my 3 yrly mammo (in England we only get them 3 yrly, and 2 yrly after bc) and didn't suspect anything was wrong. This was at a travelling unit.  About 4 weeks later I was sent a letter recalling me to a hospital in the nearest large city. I just thougt that perhaps the x-ray film was dirty - I had no palpable lump, but did have intermittent pains down my right arm, from armpit to wrist. The hospital I went to is one of only 6 centres of breast care excellence in England, so I felt I was getting good care.  

When I went into the x-ray room, the radiographer had my initial mammo up on the light box and I could see a large black mass that was spiculated like a starburst. I didn't know then, but a spiculated mass more often than not, means the lump is cancerous, but I can recall that moment vividly, and knew I had cancer.  The tech did a compression mammo, sent me back to the waiting room. Then she came back and asked my husband and I to go into another room where I was introduced to the Director of the BC Clinic, Dr. Jones who is a radiologist.  She did an ultrasound, showed us the mass, and asked if she could do a core biopsy, with local anaesthetic. It didn't hurt at all.

We were then taken into an office room, given tea in china cups and the Director introduced us to a breast care nurse. We really knew something serious was afoot as we have never had tea in bone china cups on the National Health Service before.  The told me I had a 2 cm tumour (never mentioned the word cancer) and the tissue from the biopsy would go to the pathology dept and they would call me when they had the results. They already had a date for surgery!! They asked if I wanted a mastectomy without radiotherapy or a wide local excision (lumpectomy) with rx. I opted for the latter.  I was called back 4 days later and got the bad news. I had the WLE and sample node removal,which again had to be looked at by the path lab. The tumour was invasive ductal, but more disturbing was that I also had DCIS, both cribriform and comedo, and 3/8 nodes were positive for cancer. Back in another month for total axillary removal - far worse than the WLE. One more node was positive. This was when they first mentioned chemo, since the cancer had already spread to the lymph nodes, and could have also spread to other organs, like the liver,lungs or bones. I had a CT scan, bone