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Microcalcifications please interpret my result

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Jaishiv
Jaishiv Member Posts: 6
edited February 2021 in Not Diagnosed But Worried

Hello, i am 31 years old and recently had a diagnostic mammogram. I am 3 months postpartum and breastfeeding my son. One month ago i felt a seed like lump on my right breast and went for mammogram. I emptied my breasts before the mammogram. Mammogram showed microcalcifications on my right breast and ultrasound showed nothing. I was told the lump i was feeling could be breast tissue. I am worried about the birads 3 given because of the microcalcification.

The radiologist has written ‘in the upper outer right breast there are loosely grouped calcifications, predominantly punctate and round, some possibly demonstrating layering on lateral view.No suspicious masses, calcifications,or architectural distortion. No mammographic evidence of maligancy.’

Please help me interpret this result.

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  • moderators
    moderators Posts: 7,913
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    Jaishiv, we're sorry you are here and worried, but wanted to send you a warm welcome to the BC.org forums!

    Until other members post with their own experiences and advice, you may find some helpful information in these articles from our main site:

    Mammogram Results: Breast Imaging Reporting and Database System (BI-RADS)

    Understanding Breast Calcifications

    We hope this helps! Please keep us posted. Sending our best to you!

    The Mods

  • djmammo
    djmammo Member Posts: 1,003
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    Jaishiv

    Microcalcifications come in several varieties, not all are bad as Google may have you believe.

    The descriptors "loosely grouped, punctate and round, and layering on lateral view" all lean toward the benign side of things.

    The phrase "No mammographic evidence of malignancy" was also in the report. Were you concerned that the interpreation of the calcifications was incorrect?

  • Jaishiv
    Jaishiv Member Posts: 6
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    @djmammo thank you for the reply. I am confused about the ‘layering on lateral view’ part. Can you please explain what that means and why it lean towards the benign side? My report also says loosely grouped, i know loosely is a good thing but grouped which means ‘clustered’ can be suspicious.

  • djmammo
    djmammo Member Posts: 1,003
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    Jaishiv


    "I am confused about the 'layering on lateral view' part"


    This refers to liquid calcium in a cyst. It is a benign entity.

    Click here for explanation of milk of calcium

    "My report also says loosely grouped, i know loosely is a good thing but grouped which means 'clustered' can be suspicious"


    Your assumption is incorrect.


    Bear in mind these reports are written for other physicians and not for patients, it can include terms that you may not be familiar with or it may use words that may mean something in a medical sense that is different from its meaning in everyday use.


    EDIT: Broken link repaired.

  • Jaishiv
    Jaishiv Member Posts: 6
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    @djmammo, My mammogram did not show any cysts. Thank you

  • djmammo
    djmammo Member Posts: 1,003
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    Jaishiv

    The liquid calcium is contained in micro-cysts that are not visible on US, they are very small and do not contain the usual type of fluid found in a cyst. All you see is the liquid calcium layering on the 90 degree lateral view of the breast.

    image

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
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    Jaishiv, djmammo's link doesn't seem to work; here is a working link to the same page: https://radiopaedia.org/articles/milk-of-calcium-w...

    By my interpretation of the the Radiopedia page, a fully visible cyst is not required to exhibit "layering on the lateral view". It says:

    "Entities in which this feature could be observed include:

    • fibrocystic changes-cystic hyperplasia of the breast: small crescents
    • large simple breast cysts: large crescents"

    .

    To djmammo's point, I believe that the words "loosely grouped" are meant to be interpreted together, not separately as "loosely" and "grouped". "Loosely grouped" means that the calcifications are pretty much not grouped. In other words, it's not a tight group, which would be cluster, but a loose group, which is closer to being a random scattering.

    From my understanding, everything written on your report points to these being benign calcifications, supporting the Radiologist's BIRADs 3 assessment.

    edited to add: djmammo, we were posting at the same time. Your graphic is really helpful.

  • Jaishiv
    Jaishiv Member Posts: 6
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    hello all,

    Today i had my 6 months follow up mammogram for the microcalcifications in my right breast. I was given a paper with birads 3 written and suggested to follow up in 6 months again. My doctor wont be in office till next week so i do not know what the report says. Does this mean the microcalcifications were stable with no changes? Thank you

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
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    Yup, that's what it means. That's good news!

    Usually BIRADs3 are followed on a 6 month basis for at least a year and sometimes 2 years. That's why a stable result for you today still warrants the BIRADs3 and another 6 month follow up.


  • Jaishiv
    Jaishiv Member Posts: 6
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    Thank you @Beesie. You’ve been very helpful

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
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    You're welcome! Good luck with the next follow-up in 6 months and let us know how it goes. It's alway reassuring to others to see situations where everything goes as expected.

  • Loveadiandjunebug
    Loveadiandjunebug Member Posts: 4
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    i recently had a birads 4... very worried.. had a scare 5 years ago, but after 3, 6 months duration mammograms, that was fine. This time, i need a biopsy, microcalcifications in a different area.. scared out of my head!!!!

    My biopsy is Thursday, 8/20, and due to covid I'm not allowed to have any family member in the room with me:( I'm 52 years old) , no history of BC, but my parents died young: mom, 50, colon cancer, dad, 57 lung cancer, so I'm basically screwed, to put it in real terms.

    I am basically healthy, a good weight, get 60-90 active minutes in a day, low cholesterol, no diabetes.. but.. that dang family history is going to get me eventually.. i feel:(


  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
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    What's the description of the calcifications?

    BIRADs4 simply means a 2% or greater risk of malignancy and therefore a biopsy is recommended. On average, 70%-75% of BIRADs4 biopsies end up being benign.

    When is your biopsy?

    (By the way, it is better to start your own discussion thread rather than tag onto someone else's.)

  • Loveadiandjunebug
    Loveadiandjunebug Member Posts: 4
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    so sorry, I'm new.. not exactly sure what the findings are. Just was told that birads 4 is not horrible, but iffy

  • Mangosan99
    Mangosan99 Member Posts: 38
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    Love, I was where you are about 2 months ago. Just trying to figure out what a microcalcifaction was. I would describe my lifestyle and current health similarly but my history includes a mom with survivable breast cancer twice, so I would say on was in denial on that front.

    Anyway, the waiting is the absolute worst. The possibility it could be absolutely nothing to something of concern requiring treatment is more than most psyches can handle. But, you can do it.

    I found the biopsy to be quite tolerable and my husband waited patiently in the car. It is a relatively quick procedure.

    We're here for you while you wait. If you can get a copy of your report from your online chart or pick them up from the ordering provider on Monday you may feel better having more information.

  • melissadallas
    melissadallas Member Posts: 929
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    Love, most facilities don’t allow anyone in the procedure room for a biopsy with you, even before COVID. Mine certainly didn’t. They have to stay in the waiting room.

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
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    To my suggestion, Loveadiandjunebug has started her own thread. I just posted to her there. The discussion should probably continue there rather than taking over Jaishiv's thread, and to keep all the advice and information in one place.

  • Jaishiv
    Jaishiv Member Posts: 6
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    Hello everyone, i had my 6 month follow up mammogram for my right breast microcalcification today. I was given birads 3 and asked to follow up in 12 months. I thought for birads 3 it was follow up every 6 months for 2 years Today was my second follow up. Are follow up done in 12 months after 2 6 months follow up? Thank you.

  • beesie.is.out-of-office
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    Jaishiv,

    From what I've seen here, I don't think there is much consistency with BI-RADS 3 follow-ups. The first follow-up is pretty consistently done at 6 months, although in some cases it's done at 3 months. After that first follow-up, it seems to be all over the map in terms of how many follow-ups are done, and when they are scheduled. The good news is that you've had two follow-ups that show stability, and the radiologist is confident enough to schedule the next one 12 months out.


    Breast imaging-reporting and data system (BI-RADS) assessment category 3
    https://radiopaedia.org/articles/breast-imaging-re...

    BI-RADS 3 carries a management recommendation of short-term follow-up. The recommendation should be for the modality or modalities that best demonstrated the initial finding. While follow-up protocols differ across practices, a common schedule is at 6, 12, and 24 months. Once stability is documented for at least two, and at most three, years, the finding can be downgraded to BI-RADS 2(benign). If the finding develops suspicious features, such as growth, non-circumscribed margins, or suspicious calcification morphology, then it should be upgraded to BI-RADS 4 or 5.

    .


    Bi-RADS for Mammography and Ultrasound https://radiologyassistant.nl/breast/bi-rads/bi-ra...

    • The initial short-term follow-up of a BI-RADS 3 lesion is a unilateral mammogram at 6 months, then a bilateral follow-up examination at 12 months. Assuming stability perform a follow-up after one year and optionally after another year.
    • If the findings shows no change in the follow up the final assessment is changed to BI-RADS 2 (benign) and no further follow up is needed.


  • LivinLife
    LivinLife Member Posts: 301
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    I'm glad your follow up today went well Jaishiv! Thanks for checking back in....