Cluster Microcalcifications 24mm deep

[Cowgirl37]

Scheduled for Cone Compression w/ultrasound "Right" Breast 12:00 o'clock and ultrasound "Left" Axtilla lymph node on 3/13/08.  Ordered based on a diagnostic u/s, mammo and MRI that I had done 2 weeks ago because I felt 1 lump in my left breast.    

Mammo report: there is a cluster of microcalcifications along 12:00 o'clock radial w/in right breast and they should be further investigated by magnification compression images.  They are situated approximately 24 mm deep to the right nipple along the 12:00 o'clock radial.  RMLO view, they are in the upper half of the right breast".

My ultrasound of my left breast says, "there is a 16 mm lymph node in the left axillary region.  If they are clinically suspicious for neoplasm, biopsy should be considered".  

I'm 45 years old and I had an open surgical biopsy (because I have implants) in the left breast 4 years ago for a lump that I found.  It was benign.  Left breast now shows 4 "probable" fibroadenomas and the right breast shows 2 "probable" fibroadenomas on all of the new tests.  Last week the surgeon said to follow up on the fibroadenomas in 6 months.  But the cluster of micro calcifications needs to be checked with magnification and probably biopsied, and the left axillary too.  My Mom had breast cancer.

How will they usually do the biopsy since I have implants and isn't 24mm quite deep?  (My implants are under the muscle if that helps).

How often are clusters of microcalcifications found to be benign?  I've been reading that clusters are more of a concern.

If they were to find breast cancer in my "right" breast based on the cluster, why would my "left" axillary lymph node show up on ultrasound? (it does have 4 hypoechoic solid nodules).

How do they biopsy your lymph node?  And what makes it "clinically suspicious"?


  

[Cowgirl37]

THANK YOU SO MUCH for answering all my questions.  I feel better already.  I will keep posting my results and what is happening along the way.  

I feel that a lot of times people get their answers or fears helped on this forum.  But then after their procedure or biopsy results, they forget that there are still people out there that are following along and may have similar situations and would like to know the outcome compared to theirs.  People DO care and I wish everyone on this forum the best of luck and the strength to get through what we are all facing.  

Thanks again  

[Cleveland Clinic]

Dear cowgirl37:  Calcifications are normal growths that are found in breast tissue as we age.  Calcifications that are dispersed are generally thought to be benign. Calcifications that are clustered raise concern that they could be forming around a small cancer.  Calcifications that are in between are considered indeterminate.  Once a cluster of microcalcifications has been identified, a magnification view is commonly done to further characterize this finding.  If the cluster is still apparent, a biopsy will likely be recommended.  24 mm is 2.4 centimeters or about 1 inch.  Depending on the amount of breast tissue, this may or not be “deep” in your case.  Your surgeon will be best equipped to discuss the techniques that would be appropriate in your case.  The microcalcifications in your right breast may not have anything to do with the lymph node in your left breast.  Lymph nodes are the body’s filters and can become enlarged in a variety of situations such as infection and inflammation.  Clinically suspicious would have to do with the doctors opinion based on examination and the rest of the information that has been provided by scan.  If biopsy is recommended, they could do a needle biopsy or may simply remove the lymph node –your surgeon would be the best judge or appropriate technique.

[Cowgirl37]

Did I ask too many questions?  I'm sorry.  I see you answered the four above me and skipped mine.  Maybe you could answer a couple?  

I'm concerned because my surgeon "quickly" looked over my new results from the U/S, Mammo and MRI and said, "see you in 6 months for the fibroadenomas".  At that point I said what about the cluster of microcalcifications on the right and the lymph node on the left......he looked so shocked.  He hadn't even read that part and admitted it too.  I don't feel I can ask him anymore questions as he doesn't seem to have the time.  I know I will get a second opinion after I have the cone magnification and u/s on left lymph node.

[Gladys700]

Last June I booked an operation to reduce my breasts in April this year (due to a waiting list) with a Plastic Surgeon.  I chose him after comparing him with others and I believe he will do a good job with very little scarring. My Gyno told me to have a Mamogram before the operation to be sure all is well.  He phoned me a week ago to say they have found a cluster of at least 20 microcalcifications in my left breast and as some of them are oval shapes  they are considered "highly suspicious".  I had a biopsy today and must wait 10 days for the result.  My Gyno is sure  I will need surgery.  If the result is benign he wants to take them out (but a small amount of breast cut away) as he is convinced they will turn into cancer within 5 years.  If they are malignant then a larger amount of the breast will have to be removed and he will talk about that with me later to see how much.  He has told me that I should cancel my breast reduction operation but also said that when he takes the cluster away he could maybe reduce my breasts at the same time.  My Plastic Surgeon tells me that he is trained in removing all forms of breast cancer and has already done full mastectomies with lymph glands.  My question is, if I am going to have to have surgery anyway, which doctor should I chose?  I have known my gyno for 30 years and he is probably quite specialised in cluster formation etc.  However, as I was wanting reduced breasts anyway, I feel the Plastic Surgeon is more experienced in this area and if he knows what must be taken away, then he can do both things at the same time.  Do you have any advice of which one I should chose please?

[Cowgirl37]

I posted this update on the other breast cancer forum as well, so you might see it as a double post. Some people only read one or the other.  The doctor actually answered me on this one so I want to keep you posted.

Well, I spent 6 hours at a Women's Breast Center yesterday.  Based on the above post, I was to have a spot magnification of "a" cluster of micro calcifications in the right breast and another ultrasound on my swollen lymph node in my left axilla.  The radiologist came out to talk to me before anything was done yesterday and said that he didn't see the micro calcifications that the other imagaging center had seen???  He looked a little puzzled then said, with your history I'm going to call your doctor and get another prescription and do a brand new mammo here at our facility.  Thank goodness he did.  He found SEVERAL clusters of micro calcs in the right breast.  Scattered from right behind the nipple to 22 mm deep.  Then he did the same thing about the ultrasound, called the doctor and got a new script to have an all new ultrasound.  He found 6 fibroadenomas in EACH BREAST, not 6 total as in my above post.

I'm scheduled on Wednesday 3/19/08 for a Stereotactic biopsy X2.  I have breast implants and I guess they will miss them with this machine/technique.  They will be taking several samples from 2 places in the right breast where they see the clusters.  They will leave titanium markers in the spots where they take the micro calcs from.  Yes, now I'm freaking out.  But, you'll never know until they put it under the microscope.  It is sooooo nerve wracking, I feel like my world stopped about 3 weeks ago.  I will be taking a xanax prior to this procedure.  They said I could take my own pain killers too, because I have herniated disks in my neck and I will be "uncomfortable" laying there with my ear to the table and my breast in a hole.  I don't know why they don't give everyone something to relax them for this.    

My point is, you really have to be proactive and read your reports yourself beforehand. Familiarize yourself with what they are saying.  Educate yourself.  As you can see, things can get "lost in the shuffle".  I'm still going to get a copy of my report from yesterday so I know what's up before they do the biopsy on the 19th.  I want to know  what the BIRADS score is on the micro calcs.

They have digital mammo equipment at this women's center and it's at a large hospital.  They seem really sincere, not quite as careless as others I've encountered.  I feel like I'm finally in good hands.  The radiologist said that right now he isn't worried about the 12 fibroadenomas or about the lymph node on the left.  He wants to find out about the micro calcs first.  

I'll keep you all posted and please do the same.  It helps to hear others stories.  Good luck to all.