Radiologist opinion different from doctor

[bettyelu54]

Hello.  I had my yearly mammogram a month ago and was asked by the radiologist to come back and have a diagnostic done because calcifications were detected.  Had diagnostic and radiologist report said to have another mammogram done in 6 months.  Two days later I get a call from doctor's office and she wants me to meet with a surgeon for a biopsy, saying it is better to be safe than sorry.  I was not told whether the calcifications were Macro or Micro and no BIRAD rating was given.  Honestly did not know what all that was until I read the posts here as I have never had a questionable reading.  I am 54 yrs. old.  I was told to pick up films and take them myself to the surgeon.  Can anyone give me some insight as what may be happening here?

[bettyelu54]

Just went to surgeon and after reviewing my films, he suggested we not do a biopsy because there are only two round, as opposed to irregular, calcifications and they don't look like the typical cluster micros.  They are way posterior next to chest wall and doing a needle biopsy would be a little tricky.   He would definitely have to do a surgical biopsy and he said for this type, it is overkill in his opinion.  He suggested I go for a third opinion and I suppose I will.  He said he was 98% sure they are benign by the way they look on the mammogram.  I feel somewhat relieved and if I have to wait for the 6 month checkup, that is fine with me at this point.

Thanks for all your responses and knowledge.

[iam1butterfly]

Yes... your BIRAD III catagory wouldn't necessarily sound immediate alarm bells. But, again... it's an abnormality. And, I think that opting for the biopsy will alleviate the stress of the 6 month wait... it sure gave me "peace of mind."  
As for the biopsy procedure, itself... which type that will be recommended for you will probably depend on the location of the calcifications and whichever approach the surgeon and/ or the radiologist deems appropriate. Both the stereotatic/ needle aspiration and the surgical/ incision approaches are quite different. The surgical biopsy is far more invasive as it is performed by a surgeon; occurs in a surgical facility; the patient is fully sedated (you'll need someone to drive); the incision takes longer to heal, has a greater chance for infection and leaves a more noticeable scar (mine is a faint, fine line 1.5" scar).
The less invasive, stereotatic biopsy was performed by the radiologist in the radiological/ imaging facility where the initial mammogram was done; a local anesthetic was used (I could have driven to and from had I known); and, the site of the needle probe healed comparatively quickly and left a tiny, barely noticeable puncture scar (mine looks like a dimple). During the needle process, a tiny titanium clip was inserted at the biopsy site. This serves as a marker for future diagnostic referencing and will always appear in all mammograms that follow.
As to the procedure being "uncomfortable," well... in both situations, the residual pain was minimal and quite manageable with over-the-counter meds (I used extra strength Tylenol). Plus, there was significant swelling and bruising afterward... in both biopsies. But, overall, I felt that the stereotatic/ needle biopsy the more uncomfortable of the two as I had to lie motionless and prone (face down) with my head turned to the opposite direction of the procedure, on an examination table that had an opening (for the breast to drape down). This was a very awkward and uncomfortable position to hold. But, to my surprise, there was a very kind female technician who held my hand during the entire process... which made a weird and slightly scary situation a bit easier.
Anyway, I hope that this info helps. And, do feel free to ask more questions if you think of any. Take care and good luck!

[bettyelu54]

Thank you for your response.  Since I posted I went to pick up films and read the radioloist's report.  He described my calcifications as faint in posterior right breast which appear to be inferior central.  Magnification views confirm calcifications which number 2 or 3 and are relatively coarse.  Possibly early arterial calcifications.  BIRAD - III

I will probably opt for a biopsy to be sure.  Was the biopsy uncomfortable?  Would you suggest a needle biopsy for the first time?

When I picked up films, the tech told me that my doctor always goes for a second opinion when there is anything that shows up on the film.  I am glad she is so proactive.

Again, thank you for responding.

[iam1butterfly]

The same thing happened to me in 2005 and, again in 2007. Both times, the formation of microcalcifications appeared in my right breast. And, in both situations, I was given the option to either wait the 6 months or have the biopsy. I opted to have the biopsy both times ( the 1st, a surgical biopsy; the 2nd, a stereotactic/ needle biopsy.) And, thankfully, both results returned with benign findings. However, it's quite common  to have patients wait the 6 month period and then return for a follow up diagnostic mammogram in order to note any changes. If you're okay with that approach, then inform your doctor that's your preference. After all, it's really your decision... and, I'm a somewhat surprised that you're being told; and not asked, which way to go with this. Personally, I dislike the 6 month "wait-and-see" idea... and wondering, during that lengthy period, as to whether or not I have Cancer.
But, that's just me.
By the way, these calcifications are rarely cancerous, however, it's the surrounding breast tissue, where the growths appear, that would suggest that something is amiss. Therefore, this is an abnormality, which definitely cannot be ignored. The only thing is... how and when to approach it? Perhaps, this could account for the differing medical opinions regarding your situation.