Pleomophoric Microcalcifications - BIRAD 5

[CarolinOz]

I am 44 years old, pre-menopausal.  I recently had a routine mammogram.  They found "abnormalities" in my right breast and suggested compression magnifications be performed.  I had the additional views taken on Monday.  The radiology report states "a collection of 8 to 10 pleomorphic microcalcifications near the right nipple.  These are highly suspicious for malignancy.  Biopsy is necessary."  The report also states that "there is a re-demonstration of a moderate heterogeneously dense fibroglandular breast parenchymal pattern".  I have an appointment with the surgeon early tomorrow morning and a stereotactic biopsy scheduled for later in the morning.  I know I've read that most microcalcifications are benign, but there is obviously some concern.  I'm sure I'm putting the cart before the horse, but what are the odds that this is DCIS vs. a more invasive tumor?  Are 8 to 10 microcalcifications a few, or a lot?  What are "parehchymal patterns"?  Also, what can I expect from the biopsy itself....recovery time, pain, etc?  

[CarolinOz]

Update....I just received the biopsy results and they were benign!  I had read that microcalcifications were normally benign, but with a BIRAD rating of 5, thought my prognosis was probably pretty grim!  After reviewing my mammograms, the surgeon is confused as to why the radiologist would give it a 5 rating, but thank goodness he was wrong!

[Cleveland Clinic]

Dear CarolynOz:  Microcalcifications occur normally in the breast.  The pattern of microcalcifications gives clues about them.  Microcalcifications that are widely scattered are likely benign.  When microcalcifications are clustered, there is more concern that these are growing around an abnormality.  There is no way to guess at the odds of benign versus DCIS versus invasive cancer – however a BIRAD 5 indicates a pattern that is concerning for malignancy.  Breast parenchyma is the description of the breast tissue.  In short, the report suggests that you have dense breast tissue.  In general, women tolerate stereotactic biopsies very well, minimal discomfort and short recovery but you should discuss with your surgeon who can respond based on your situation specifically.