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Mar 5, 2009 10:32PM, edited Mar 5, 2009 10:34PM
Full of life: Back in September, I was faced with the same thing you are--what to do about microcalcifications. I ended up having a stereotactic biopsy, and then a needle-guided excisional biopsy. The stereotactic biopsy found certain abnormal cells growing in an unorganized fashion.
You are right; a group of microcalcifications does not equal a lump, but they may still need to take out a portion of that area of the breast to see what the abnormal cells are doing, if you have any, and they call it a lumpectomy anyway.
By the way, the needle placement done before the excisional biopsy to make sure of targeting the area of the calcifications was simple. (Just having the breast numbed while sitting in a chair and having a less-painful-than-usual mammogram done right there to make sure the needle was in the right place. I felt nothing and it was not scary.)
In the end, I was glad I had the stereotactic biopsy and the excisional one, because the latter found ductal carcinoma in situ--that is, cancer in the ducts that had not begun to spread outside. This is about the earliest you can find cancer. I had to have a second excisional biopsy to make sure that there was a large enough clean (no cancer) margin around what they removed the first time, and this time, the surgeon said they had got it all. I was asked to consult a radiologist and then an oncologist about the necessity for further (preventitve) treatment, but both of them said it wasn't necessary. I will continue to have regular checkups and mammograms.
What was strange and makes me doubly grateful for the skill of the technician who read the mammogram that first alerted them to the problem, is that someone along the line wrote in his biopsy report that he couldn't detect calcifications, and again, when they took a mammogram after placing the needle for the first excisional biopsy, the operator said how strange, he couldn't see any calcifications there. But if no one had noticed them and I had had nothing done, I could have an undetected and untreated cancer developing in my breast right now.
I don't know about using stereotactic needles for targeted chemo treatments for breast cancer, but something similar exists for liver cancer, which my husband has (though he refused the treatment). It is called TACE, or transarterial chemoembolization. They have other targeted methods of treatment, too.