microcalcifications and breast cancer.

[Whackadoo3296]

I am 44 years old, and finally went for my 1st baseline mammography.  I have a significant history of breast CA in my family. They found an approx 4cm cluster of microcalcifications and I was referred to a surgeon.  The surgeon did not have one optimistic word regarding these microcalcifications, and when I asked him the chances of them being malignant, he told me that to be honest the cluster was "highly suspicious", but if it was breast cancer it was very early and very curable.  My question, is, would a surgeon that deals mainly in breasts have such a "gut feeling" through experience, or does my significant history play into the picture for his thoughts that it could be cancerous?  Also, are there statistics on how much your risk for breast cancer increases with a significant history?  Thank you in advance for your answer.

[believe2b]

A related discussion, microcalicifications was started.

[Montana girl 06]

This thread is from 2004 so you won't get an answer from the surgeon. But, as a woman with continual problems with calcs I can share what I know. My surgeon told me needle biopsy (as in stereotactic biopsy) is about 98% accurate so you should get a definitive answer on your calcs. But, I've also had two excisional biopsies. The area removed each time was small (peanut M&M size or a bit larger.) The area filled in just fine and I don't feel disfigured at all. Do you know how large an area they plan to remove? Macrocalcs are nothing to worry about. They are considered benign. I'm refering only to the microcalc cluster.

No one is sure, why the breast lays down microcalcifications. One theory is that with malignant/premalignant conditions, there is an abnormal production and turn over or death of cells. With cell death, calcium is a by-product. (I quoted this from another source.) But, formation of microcalcs is also a normal part of aging. They can also be caused by injury to the breast. These  two reasons are causes for benign calcs. When calcs form certain patterns they look suspicious. But, often they can't tell if the calcs are benign or malignant without a biopsy. 85% of microcalcs are benign. Another source I have states that only about 25% of suspicious calcs (suspicious enough to have a biopsy) are malignant and then they're almost always a very early cancer.

Hope this info helps.

[CCF-RN,MSN-rf]

Dear Whackadoo3296:  Likely, your surgeon made his comment based on experience.  It's possible, your family history may have strengthened his suspicion.  Bottom line, though, is that the only way to be absolutely certain is to biopsy.  There are statistics that relate to risk but these are associated with multiple factors (like who had the cancer and at what age) as well as other risk factors you may have.

[surgeon]

It's not really a matter of "gut instinct." It's knowing that there are various things that cause microcalcifications, and that certain shapes and patterns indicate certain likely causes. There are some patterns that, from appearance alone, can be seen to be not worrisome; and there are others that when seen indicate a strong possibility of cancer. "Risk" is a statistical thing: if you have breast cancer in the family in mother or sister, and they got it before menopause, your risk is significantly increased. However, that's really only a number useful for looking at populations. For an individual, when there's something of concern, it needs an answer, no matter what the risk factors are. Not all women with risk factors get cancer, and not all cancers occur in women with risk factors. In general, how a surgeon would approach a given lump or mammogram finding would have to do mostly with those specific findings, and not the risk factors that a woman might or might not have.

[ann440]

A related discussion, re cluster of microcalcifications was started.

[Connie59]

A related discussion, I have to have a breast biopsy. was started.

[becki40]

A related discussion, hurry up and wait was started.

[gale_storm59]

I have just been through repeat mammograms it showed micro and a macrocalcification cluster in left breast . BC history in grandmother death resulting  mothers side and several aunts also mothers side family history on dad's side not avail. Question is needle biposy is my choice  for biposy terrified of being disfiqured by an incision but does that leave me @ higher risk of missing a correct diagnosis???What are the percentages of positive for CA with microcalcifications and what other disorders of the breast could cause this condition?gale_storm59

[Whackadoo3296]

Alivia try to stay calm, not all calcifications are malignant - they are doing more pictures so they could get a better look.  I know with family histories like ours (mine is also on my mother's and father's side) it's so easy to think the worst.  But no need to panic yet until the results come back (of course with my biopsy day after tomorrow I'm not one to talk about panic - it's more like terror).  Good luck, and post a note to let us know how it went.

[alivia]

I just ahd a mammogram  last week  amd was told i have  calcifications     in my right breast...... I have history of BC in  both mother and father side...mom  died with it   i'm  really scared  and  have  to go  this week  for another mammogram.....dr   has  not  said  anything  to ease my fears   just  that i have significant risk    good luck to all of you

[Kathy Q]

I was going to ask while I was at radiation this morning.  That's what I thought it was.  A maximum local dose.  As always, this forum fights fear with information.

Thanks!

Kathy Q

[Kathy Q]

Your situation sounds very similar to mine.  Suspicious microcalcifications.  I skipped the simple needle biopsy and went straight to the needle localization excision to get a difinitive answer.  It was DCIS.  Had the first re-excision and didn't quite get clear margins.  Had the second re-excision and got clear margins.  I've had the first 9 (of ~30-35) radiation treatments with no side effects so far and am very happy with the diagnosis and treatment I've received.  I have the word of my surgeon and plastic surgeon that they will go to bat for me with my HMO if I am unhappy with my appearance after I've finished the radiation and let everything settle down again.

This forum was a wonderful place to ask questions that prepared me to hear and absorb the information when I was asking my various doctors about the options ahead of me.  I am very grateful I found this forum.  I hope all turns out well for you.

Kathy Q

[surgeon]

there's only so much radiation a given area can take, but having it in one location doesn't preclude having it elsewhere at another time for another reason. If one has breast radiation, and the cancer returns in that breast, then more radiation there is not an option, however.

[Kathy Q]

That is a good question.  I'm under the impression that I've only had the maximum radiation for that breast, but I will ask my radiology oncologist this week.  Although my first choice might have been to have a mastectomy and reconstruction rather than radiation, I found myself living on the east coast, 3000 miles away from family and friends as this was all rolling out.  Given the support system I have in place where I now live, I opted for radiation, which I could handle solo.  Had I still been living on the West Coast as I went through this decision process I most likely would have chosen the mastectomy with reconstruction or mastectomy with implants.  Just for the peace of mind.  But it was just too much surgery with too much care required for me to manage with my current living situation.  

Ask your surgeon, radiologist and oncologist all these questions to get enough information to make an informed decision on what's best for you.  On the other hand... maybe you'll go the the biopsy and not have to deal with the options.  Either way, it doesn't hurt to prepare yourself, given your family history.

One other piece of advice...  DCIS is not invasive (if that turns out to be your diagnosis).  You can slow things down enough to really do all the research you need to do to satisfy yourself that you're making the right decision for your situation.  Don't let yourself get rushed.  Take the time you need.

Kathy Q

[Whackadoo3296]

That could be very true about lifetime radiation, to tell you the truth I don't know much about it.  But tomorrow when I go to work believe me I will hunt down an oncologist and ask him.  Although my support system is a little better, the closest family I have is almost two hours away.  I'm a single parent of 4 teenagers, and their dad isn't in the picture anymore, so that will also influence my decision.  But you're right, it still could be benign (at least that's what I'm praying for).  In the meantime I'm grateful for this site, it helps me to see things realistically and to realize that I'm not alone.  Thank you everyone for your input, it's a great comfort to me.

[Whackadoo3296]

That's my fear with having a lumpectomy.  Truthfully, I don't want to go back again.  I want to do it once and have it over.  Also, does the dose of radiation give you your lifetime dose?  I don't mean to sound cryptic, and maybe it's because I'm also a Registered Nurse, but I'm only 44 ..... I could have many years to have something else horrible happen that I might need radiation for - if you get your lifetime dose it won't be an option.  Is it worth it for a cancer that could be surgically treated (I also have a history of other types of cancers), And I have a strong family history, with one cancer in my breast the odds of having another cancer arise in the same breast or the other one (that's how my aunt died, they found the new cancer too late), is significantly higher.  My surgeon recommended a bilateral mastectomy with my history (over 8 relatives have had breast CA).  I don't know if that's being way too radical a treatment option, or, if I go for a lumpectomy will I spend a little more time than usual obsessing about getting a new cancer?  I just don't know what to do.

[Whackadoo3296]

Thanks for your feedback, you're right he does think it's DCIS.  I will have a needle biopsy this week, and if that's negative a surgical biopsy will follow.  If positive ... well, that's still a decision .... lumpectomy or mastectomy (I just hope it doesn't come to that).

[ritavv]

Until you get your official answer, I thought I'd throw in my comments.  I don't mean to frighten you but there are certain patterns of microcalcifications that are more suspicious than others.  I do feel that the 'gut feel' is often accurate.  I have a strong history of BC in my family.  I had many many lumps and the doctors were never too concerned.  They just followed them to make sure there were no changes or that they were cysts.  Then 3 years ago I was told that they would be very surprised if my latest lump wasn't cancer.  It was.  Later I too had microcalicifications.  They were suspicious but the gut feel was they probably weren't from cancer.  However, I  needed a biopsy to be sure.  The biopsy was negative for cancer.  

Hopefully if yours is cancer, it is DCIS.  It sounds like it could be.  Good luck.