Calcification

[tejodouro]

I am 50 years old and always had my annual mammograms.  Last year, I did not.  I went last week (19 months since my last one) and the mammogram showed four calcifications on the left side of left breast.  The doctor told me that they look benign (no biopsy) and that I needed to come back in 6 months for another mammogram to see if they disappeared or grew and need to be biopsied.  Is this normal protocol or should I be conserned and obtain a second opinion?  I do not know much about breast cancer and mammograms since I always had normal ones.  There is no breast cancer in my family.  I am worried that I wait 6 months and I regret wasting time.  Should a biopsy be done at this time? How does he know that these calcifications are benign?  Thank you.

[zouzi]

Hi.
Radiologists are able to identify typically benign breast calcifications depending on their form and pattern.If no suspicion is detected a biopsy is not required to prevent unnecessary procedures and to reduce patient anxiety.
The report on your mammogram could be a Category 3,"probably benign finding" to have suggested a short-interval follow-up.( check your report or call the radiologist to find out about your BIRADS score)
BIRADS score 3 is used when a noted finding has a very high probability of being benign.The finding is not expected to change over the follow-up interval, but the radiologist prefers to establish its stability over time.
The BIRADS score,go from 0 to 5 and this terminology is used by radiologists to describe mammography findings.
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0 - Incomplete - Additional tests are necessary to further evaluate the findings, or follow up may be needed

1 - Negative - No imaging findings; recommends routine screening

2 - Benign - There are mammogram findings, but benign in nature; still recommends routine screening

3 - Probably Benign - Breast mammogram findings are most likely benign (>90%), short term follow up test is necessary

4 - Suspicious - Breast findings have probability of a malignant nature, biopsy is recommended.

5 - Highly Suspicious of Cancer - The breast findings have a very high chance of being malignant (>90%). Biopsy or more definitive treatment is recommended.
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I really wouldn't worry so much if I were you and I agree with nc michigan,because what your radiologist has recommended is standard procedure.If the suspicion about these calcification were more elevated,a biopsy would have certainly been ordered.
If you still feel uncomfortable waiting six months for a follow up,you could have your films read by another radiologist for a second opinion.
Best wishes...

[ncmichigan]

Calcifications are common. It is only when they are clustered or form certain patterns that they could be of concern. Even then, they are most often the result of some benign changes in the breast. Follow up in six months is the normal protocol for scattered calcifications. Experienced radiologists know when the calcifications look suspicious and will recommend biopsy. You can always get as second opinion, but it really doesn't
seem necessary based on what you've told us so far. I know this from personal experience, as I've had calicifications that required biopsy and some that they're just watching every six months. I know the waiting is stressful sometimes (it is to me, too), but worrying about "what ifs" won't change anything. Others here may have additional information for you but  I hope this is at least a little helpful.
Wishing you all the best,
nc