Microcalcifications

[CP@AIG]

I am a 48 yr old female w/ hx of Stage I adenocarcinoma of rt breast, diagnosed in 1995, treated w/ lumpectomy, chemo (CMF), & radiation.  I have a very strong family hx of breast ca- mother & maternal grandmother (both had recurrence), maternal aunt, and younger sister. I have developed areas of microcalcification on mammogram since tx was completed,including some areas requiring bilateral stereotactic needle bx in 2001--(bx negative).  I now have new microcalcifications that have developed in the rt breast near the prior lumpectomy site and bx is scheduled for next week.  Mammograms done prior to my breast ca dx were always WNL.  Is it common for these microcalcifications to develop after tx for breast ca? Is there any increased risk of recurrence associated w/ the development of the microcalcifications?  Is their proximity to the lumpectomy site of any concern?  Thank you for your help!

[CCF-RN,MSN-rf]

Dear CP@AIG:  Microcalcifications are not a risk factor for breast cancer.  Rather, they form as a result of a variety of things, including scar tissue or cancer, to name a few.  The appearance of the microcalcifications will often give clues as to whether further investigation needs to be done or whether they can simply be monitored.  Calcifications near the lumpectomy site are not necessarily more concerning than calcifications elsewhere in the breast.  However, your history of breast cancer may make the threshold for evaluating calcifications a little lower.  Either way, though, a concerning pattern of calcifications would require further evaluation.

[surgeon]

microcalcifications are common in the breast, and can be due to many different things: they are not per se a risk factor, because they are the result of whatever process is causing them, not a cause. Based on your family history, your risk of new cancer is elevated: but it has nothing to do with having calcifications. Calicifications near the original site are of concern; but they can be due to scar tissue formation. With or without family history, and with or without personal history, new calcifications need to be addressed. Some can be discounted by appearance alone; others need, as you have had, definative diagnosis.