BiRADs 3 vs 4A: grouped microcalcification

[Connie78]

The more I read, the more worried I became...

I had an excisional biopsy last Nov and it found atypical ductal hyperplasia (ADH), and mucocele-like lesion, adjacent to a fibroadenoma. I was warned by a friend (who is a pathologist abroad) the possibility of DCIS since he believes that mucocele-like lesion is not common in benign changes and ADH made it suspicious. I double checked it with a 2nd opinion and it had the same diagnosis.

Last week I had twice digital mammograms, one with magnification, and it found 'Grouped punctate and amorphous calcifications in the upper outer quadrant adjacent to the surgical scar'. The radiologist gave a CATEGORY 3 (probably benign) vs 4A (Low suspicion). Although she said it might be ADH again, or benign changes after surgery, there is still some possibility of malignancy (DCIS or something) since I had ADH adjacent to the fibroadenoma. I am going to see my surgeon tomorrow and will have a biopsy soon.

I kept on worrying if there is DCIS, or DCIS with invasion, or even worse...I heard that grouped amorphous microcalcification is bad...so worried.

[Connie78]

My pathology report came back as "Multiple foci of atypical ductal hyperplasia, in a background of columnar cell change and flat epithelial atypia, associated with microcalcifications (grouped punctate and amorphous microcalcifications)".

And my pathologist kindly told me more details that "We did not feel that the atypia was suffciently severe to say that this was bordering on DCIS. But, the atypia was fairly widespread throughout the biopsy."

Hope these information could be useful to others with BiRADs 4 before biopsy.

So I have WIDESPREAD ADH. And I do want to have kids as soon as possible. Honestly I don't know if I have the time to have kids before anything bad will happen.

[Connie78]

Thanks a lot.

[japdip]

Many BIRADS 4 ratings due to microcalcifications do come back as benign. There are percentages but they vary so much I never quote them. It's a pretty fair number though. As you know only the biopsy can diagnose and the waiting is never pleasant. It's best not to stress over these things and I know that's almost impossible .... do your best though and good luck with the biopsy.   Regards ....

[Connie78]

HI, I am really worried about cancer now. Does "grouped microcalcification" ever turn out to be not cancer? I am really scared now. My surgical biopsy will be in 2 weeks.

[japdip]

Grouped microcalcificaitons are always cause for concern. They are the reaction of the breast tissue to some abnormality within the breast. Usually with ADH there is excision with possible follow-up treatment; sometimes Radiation and Tamoxifen (depending on Estrogen positivity). I think you are wise to keep the investigation going ... perhaps your next biopsy will answer this latest concern. Best Wishes .....