Abnormal mammo and upcoming biopsy

bayside72
bayside72 Member Posts: 7
edited May 2023 in Waiting for Test Results

Hi! New here. So on May 4, I had a mammogram and also a right breast ultrasound due to some pain. Ultrasound came back fine. The screening mammogram showed some concerning calcifications on right breast which they then magnified on a 3-D ultrasound at least that’s my understanding. Radiologist came in and said I have one group of just 3 calcifications. She said she wasn’t too worried because usually 5 or more is concerning. She also mentioned it looks like my last mammogram a year and a half ago they were calcifications, but that radiologist did not ask for magnification, and did not note them so that he must’ve not been too concerned. I was surprised by this, I was not even talk about those .I was super anxious and she reassured me again she wasn’t super worried, but that if it was breast cancer, it would be early stage.

Her recommendation was a 6 month follow up mammogram. Maybe to the average person this was acceptable, but I have severe anxiety so I told her I didn’t know if I could wait six months and asked if I had any other options.? She then said she didn’t ever want to cause a patient undue stress so she would order a biopsy for May 16th. I left telling myself it’s gonna be OK. The doctor wasn’t too concerned.

fast forward a couple of days and I got the my chart report from my visit. Her written report vastly differed from our conversation. I was put in a bi rads 4 B category, which I researched and found that shows 10 to 50% chance of malignancy! I was confused and freaking out. I’ve tried to reach the radiologist and every time I call the office I kid you not, I am in a queue of about 40 callers I request a call back and never get it. And for some reason you can’t message the radiologist on your my chart.

anyways, the report said I have someone dystrophic calcification? I’m attaching screenshots of it here.
Tuesday is the biopsy and I just keep going in my head to worst case scenario. Has anybody else have this situation and what was your outcome?I have four kids raging an age from 14 to 26 and I just wanna be around a long time for them.

I’ve also read doctors will sometimes upgrade the Birads categories so insurance will cover biopsy is that true? Just looking for some glimmer of hope.and I don’t know if it matters but there’s no family history of breast cancer.

thank you for reading my very long post.

Comments

  • maggie15
    maggie15 Member Posts: 1,386

    bayside72, I'm sorry that you have to go through the worry of a biopsy. Dystrophic calcifications are probably caused by inflammation rather than cancer but there is no way to be certain other than a biopsy. No family history of breast cancer is not a guarantee. BIRADS 4b means that it is more likely benign than malignant. Also, insurance requires a score of 4 before they will pay.

    The wait is difficult so try to stay busy to take your mind off it. Let us know how it turns out. Here's hoping for benign!

  • bayside72
    bayside72 Member Posts: 7

    @lotusconnie1999 @maggie15

    I can’t figure out how to reply individually so to Connie and Maggie, Thank you so much for all the great and insightful information and advice!
    in terms of the calcifications, I was unclear whether she was saying they were each 3 to 4 mm or total together but you are right she did not call them micro. Idon’t know how I missed that ha ha

    Thank you for the input on staying busy and getting stuff done. That is actually really smart and I am going to make myself do that! Ruminating and researching endlessly has not been good for my psyche.

    Connie, I hope your enhanced screenings continue to come back with good news.

    I will update with results! Have a great weekend!

  • mavericksmom
    mavericksmom Member Posts: 1,275

    bayside72, I have had breast cancer 3 times. 2003, IDC, 2018 ILC (same breast) and 2022.

    I have been in your shoes, sort of. When I had my second cancer, I had a left mastectomy. I wanted both removed but my doctor refused to do that, worse yet, he lied and said the reason was that the hospital policy was never to remove a healthy breast.

    Last spring I decided I didn't want to continue to have mammograms at the cancer hospital I was treated at and so I had all my records transferred to a local, large, hospital. I saw a breast surgeon there who absolutely wanted to continue to see me for follow up care. He gave me a script for a mammogram which I had in July.

    When I went for my mammogram I expected to be in and out of the women's center fast, especially since my mammogram was only for one breast. I had a hair appointment scheduled for later that same morning.

    That didn't happen. After more views the radiologist called me back and told me that many calcifications showed up that were not there last year. He thought it was likely DCIS, which is cancer that hasn't broken out of the ducts. They scheduled me for a biopsy the following week and I got the results two days later. It was DCIS with microinvasion. My new surgeon agreed I should have a right mastectomy. His words were "I don't want to leave you with any breast tissue!" Of course that is never possible, I know that, but it showed how concerned he was.

    Radiologists are VERY good at determining if something looks like cancer. That is not to say they are perfect, or always right, but they do tend to know what they are talking about. I suspect your issue is benign, but I also think you should have the biopsy. Most biopsies (so they say, I was 3/3) are benign. You will get peace of mind and you don't need to feel guilty for wanting that.

    The language in your report seems to support benign, but again, the biopsy is definitive. I suspect if it turns out to be cancer, which I don't think it will, it would be early DCIS.

    Always better to error on the side of caution. Relax as best as you can, don't worry about contacting the radiologist, and see what the biopsy results say. I think the fact that she doesn't want you to worry for six months speaks volumes for her! She is not only a good radiologist, she is compassionate!

  • bayside72
    bayside72 Member Posts: 7
    edited May 2023

    @mavericksmom Hi! Thank you so much for all the re assurance. And yes, I was super impressed with the radiologist. She was actually only filling in there for the vacationing radiologist, the one who I’m presuming didn’t mention my calcifications a year and a half ago. This fill in radiologist is at a different clinic that is about 45 minutes away from me but I think going forward I’m going to transfer care to there. She didn’t even hesitate about the biopsy. She’s like yep let’s do it we don’t want to cause you undue stress.

    and I am so sorry to hear what you have faced.wow! I would’ve been so upset with the doctor that refused to operate on both breasts years ago. That would have prevented your latest cancer about would it not? How are you now? Did you have to do chemotherapy even with the second mastectomy? you have been through a lot! You sure deserve a break❤️.

    thank you again for your thoughtful and thorough post. I will be updating on this site when I get my results.

  • mavericksmom
    mavericksmom Member Posts: 1,275

    bayside72, sounds like a good plan! Make sure your insurance will still cover expenses at the other hospital, but if so, it sounds smart to have that radiologist who ordered the biopsy, do your biopsy. I assume the biopsy is done by the radiologist where you go. My first biopsy in 2003 was done by my breast surgeon, but both in 2018 and 2022 it was done by radiologists.

    Hopefully it something benign, but at least you will have confidence in the results!

    I am sorry my doctor lied too! My husband was with me for that visit, so it wasn't just my word against the surgeon's! My feeling is that someone at the hospital knew he was lying to patients but didn't say anything to anyone who could or would, do something about it. He was older, and I think he was just sticking to his beliefs, and trying to do what he thought was best for me. Regardless, I deserved to be told the truth!

    The real "kicker" came after I was diagnosed again in 2022. I wrote a letter to one of the breast surgeons, because the breast surgeon who lied to me sadly passed away in the spring of 2021, and I asked them to reconsider "their" policy. I wanted to try to prevent what happened to me from happening to someone else. Long story short, the letter was sent up the "chain of command" and I got several certified letters from the person handling it, that they were "reviewing" my concerns. I finally got their answer which was that "it was never the hospital policy to refuse the removal of a healthy breast in high risk patients like myself."

    The REALLY sad part is that his lie didn't just affect me, it affected my family, friends and about 170 students I worked with in a middle school, as well as the teachers I worked with. Because of my breast cancer diagnosis, I was out on short term disability for several months in the fall, and then I retired in early February. I planned to retire in June, but things didn't work out that way. I just physically couldn't continue to work. The point is, one surgeon's lie affected a lot of people!

    I am doing pretty good now. My first cancer in 2003 was when I was premenopausal and I was treated with two lumpectomies, the second was for clean margins, chemo, 4 rounds of ACT and 34 rounds of radiation. I didn't have chemo after my first mastectomy because of my Oncotype score. I didn't have it after the second mastectomy either.

  • bayside72
    bayside72 Member Posts: 7
    edited May 2023

    @mavericksmom
    oh wow! I am at a loss for words! Even if he thought it was best for you he should have had an honest discussion with you about his concerns.
    yeah, no doubt his lie had a HUGE-ripple effect! Again, I’m really sorry you went through all that!. On a different note it’s funny, I work in a middle school too as an instructional assistant.

    you seem so upbeat for all you’ve been through, I’m glad to hear you’re doing well now. Sending good thoughts that will continue.

  • mavericksmom
    mavericksmom Member Posts: 1,275

    Thank you, bayside72 and lotusconnie1999!

    I carried around a lot of anger over the surgeon's lie. I even shared with people here, different forums, and I received a lot of support from others on this message board, which is why I love BCO so much!

    Some might wonder why I didn't see another BS for a second opinion. He told me I was welcome to do just that, and referred me to several other doctors at the same hospital. Why would I do that? He said it was hospital policy and I believed him, so assuming that was true, any other doctor in the group would say the same.

    It should have been a huge red flag, I absolutely made the mistake of not going for another opinion elsewhere. But, I was in shock at the time. I had IDC over 15 years prior and I was told the chances of me getting breast cancer again were slim. I went through horrific treatments, was sick to the point of vomiting for three of the four rounds of chemo, and was literally burned, as in jelly bean size blisters and sloughing off of skin, from radiation.

    When I went for my mammogram in November of 2018, I made the appointment for after work, I worked in a middle school. I assumed I would be in and out and home by 4:00. I was there until after 7:00! Even when I went for my biopsy, I was not at all worried I had cancer. I literally went into shock when I found out I had ILC!

    I think many have experienced the same. When one is in shock at the diagnosis, it is not a time most feel comfortable going for a second or third opinion. I think the gut reaction is "get this cancer out of me now!"

    If there is one thing I would tell people is, that if a doctor refuses a bilateral mastectomy that you want, ABSOLUTELY, 100%, get a second opinion somewhere else! If I could go back in time, that is what I would have done.

    Since hindsight is 20/20, I realized a year or so afterwards that there was no way I was going to have another surgery to remove my healthy right breast, and that carrying around the anger wasn't helpful. I let it all go.

    My biggest regret is that the surgeon who lied to me passed away in 2021. He had ironically been promoted to dean of the medical school that the hospital was affiliated with! I never got closure being able to tell him that my right breast was no longer "healthy!"

    Oddly, when I was diagnosed in August of 2022 with IDC in the right breast, I felt better because I had met with my BS prior to having my mammogram that was BIRAD 4. If I hadn't like him, it would have been so easy to see someone else at that point!

  • maggie15
    maggie15 Member Posts: 1,386
    edited May 2023

    Hi all, The doctors you end up with often are just a matter of luck. When I called to make an appointment after my diagnosis I was assigned a BS, MO and RO. I met with the surgeon only first and was very happy with her. She said that second opinions are welcome but not within the hospital unless the surgeon assigned is not an expert in the surgery you prefer (like aesthetic flat closure.) My MO assignment changed before my first postsurgical appointment where I met with all three doctors. The surgeon told me the change had been made since, having talked with me, she felt I would click better with the new one. My MO is primarily a researcher and loves discussing the science behind options which really suits me.

    It's hard when you have no choice. In my rural area the only doctors within an hour's drive are all at the small hospital. You are assigned a PCP which spreads the workload fairly but you are not allowed to change providers. Initially my doctor's lack of interest didn't bother me since I was pretty healthy for many years (other than hypertension which he never treated.) It came back to bite me when I ended out with two emergent surgeries because he ignored radiologists' recommendations and a much larger tumor since he assured me that what I felt was just a cyst based on my recent birads2 mammogram and low risk score on a nomogram. Thankfully he retired and my new PCP as well as the specialists I see locally are all OK. Now I travel to a big hospital for anything that is not straightforward. The large majority of doctors I have dealt with during my life have been fine but, as mavericksmom said, you should not put up with one who ignores your concerns. In retrospect I should have made an appointment with ob/gyn where the providers would have been more likely to investigate.

    Bayside72, I hope your biopsy is benign and you don't have to worry about surgeons.

  • mavericksmom
    mavericksmom Member Posts: 1,275

    bayside, thinking of you! I hope the biopsy went well for you.

    I had each of my three biopsies, different years, on a Tuesday. The first and second time, it took a full week to get results. (Tues biopsy-following Tues results) The last time I got the results in two days (biopsy Tuesday, results on Thurs).

    All three were positive for cancer so do not let time make you think it has something to do with the result.

    I hope you get results quickly! Remember, we care, either way, I hope you post again. We are here to support you!

  • bayside72
    bayside72 Member Posts: 7

    my doc called today. It is ductal carcinoma in Situ He has sent referral to some kind of breast specialist doctor. It’s all a blur but I think he said it is best kind to have I guess. Stil though am scared. Haven’t seen the report on my chart for more info.
    so that’s where I am at. Thank you for checking in❤️

  • mavericksmom
    mavericksmom Member Posts: 1,275

    While upsetting for sure, it is the “best kind”! It is Ductal cancer that hasn’t broken out of the ducts.
    I am SO glad you listened to your body and had the biopsy! Six months from now it could have become Invasive Ductal Carcinoma!

    You need time to process all of this but Maggie and I and others, are here for you! You aren’t alone!

  • moderators
    moderators Posts: 8,650

    @bayside72, we're sorry to hear of your unwelcome news. Hang in there! As you can already see, the boards are full of support just waiting for you.

    Besides this forum, we'd like to suggest you check out also the Just Diagnosed Forum and post your story and questions you may have there, start a new discussion, or check out the DCIS forum and do the same.

    You may also be interested in these Important Links about DCIS.

    We hope this helps! You are in our thoughts, and we look forward to hearing how you are doing.

    Warmly,

    The Mods

  • bayside72
    bayside72 Member Posts: 7

    Thank you.❤️

  • maggie15
    maggie15 Member Posts: 1,386

    bayside72, I'm sorry that you ended out with DCIS and need treatment. Hopefully you will feel a bit better when you have more information and a treatment plan in place. Mavericksmom is right; this is a good place to get information and support as you deal with this. All the best going forward.

  • bayside72
    bayside72 Member Posts: 7

    thank you❤️