Indeterminate Micro Calcifications
Hello everyone,
I am 54 years old with dense, fibrocystic breasts. I am going through menopause (blah). I had my annual screening mammogram on January 13th. On January 15th, I was told the radiologist had found an asymmetry in my right breast and scheduled for a diagnostic mammo and ultrasound on Monday, January 25th. After many, many pictures and a long ultrasound procedure, they called back on Tuesday and told that the radiologist had found two clusters of microcalcifications in my right breast. The one at 9 o'clock was very likely benign and they just wanted to follow up with another diagnostic mammogram in 6 months (Birads 3). The one at 10 o'clock is "indeterminate" and a Birad 4. I asked and they told me that it hadn't been categorized as a 4a, 4b or 4c. My biopsy is scheduled for this coming Tuesday. Of course, I've been looking up microcalcifications online and am very freaked out!! I've read that only 20% of these Birad 4 microcalcs end up being cancer, but then somewhere else I read it could be as high as 70% for Birad 4C.
I spoke to my doctor and she did not give me much info other than that they see more benign biopsy results than malignant. Very stressed out right now. Don't know how I'll get through the weekend! Any info or advice would be very appreciated.
Thank you. This is truly a wonderful and supportive group of women.
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hi there,
I feel your anxiety! Found out today I need a biopsy for them too and of course I'm freaking out. I don't know the birad number because I was too freaked out to remember to ask the radiologist. I of course have been googling these topics since I found out I needed the diagnostic mammo early this week. I'm waiting to make an appt for the biopsy but was told I'm too small breasted for the usual kind so will need an excision which is basically surgery. I never even knew about microcalcifications. Hang in there! You're not alone.
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HI ladies and welcome.
First rule...>STOP GOOGLING!!!
There is so much out there that just is not helpful or even accurate.Dr Google is not diagnostic. :P
Know that MANY MANY things can happen to our breasts that have nothing NOTHING to do with cancer (ESP if you are going thru menopause, Flamom). Most biopsies come back b9, even for a BIRAD 4. It sounds like you both have good doctors who are being prudent. That is a good thing.
Nothing either you have posted is raising alarms in my experience. It does make me think you have good doctors who are looking out for you. My advice for both of you, enjoy your weekend....STAY OFF DR GOOGLE....get your biopsies done and if in the unlikely chance your biopsies come back with something other than B9 results (and there are other kinds of results that can come back that are not cancer), get copies of your reports and come back here.
But seriously, neither of what you guys have posted sounds alarming. Sounds like something looks different in your mammos and your Drs are wanting to know why that is.
HUGS
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Thanks for your response Marie. It was so reassuring! I will touch base after the biopsy.
BTW, my younger daughter is heading up your way for college at Wesleyan next year! She's very excited.
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thank you Marie! I know Google is not our friend. I tend to suffer from anxiety in general and this past year it's been worse than ever so I'm not handling this well. I am waiting for the appt. And need to have my records sent over hopefully Monday to the breast clinic, which isn't part of the medical group that did my images. Thanks for posting and I'll hopefully feel better when the biopsy is scheduled.
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Went for my biopsy yesterday. Got the results a few minutes ago - no evidence of malignancy! Feeling extremely fortunate. I have ductal hyperplasia (the report noted no atypia) and PESH so I will be under the care of a breast specialist going forward. Any thoughts or comments?
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FLAMom,
YAY for no malignancy.
I, too, was DX-ed with PASH (not PESH). It's a B9 condition that is a bit more rare. Normal protocol is to surgically remove it. Since mine was small, didn't seem to be growing (and it can), and closer to chest wall, my breast surgeon was very comfortable with my decision not to have it removed unless it began to bother me. It never did, and is sometimes the case, it went away on it's own.
(Please note that this article is quite old. 1995)
The ductal hyperplasia just means an over growth of cells. the "no atypica" is good. It means that the cells didn't look unusually deformed. sometimes having "ductal hyperplasia *with Atypia means one is at a *slighter (and I stress slighter) higher risk of developing BC.
You have been given a good report. SO exhale!!!
(Happy dance).Have a good discussion with your breast specialist. Remember what I said. Normal protocol for PASH is surgical removal. You may want to do that, or not. But have a good discussion. You could also opt to wait and see what it does before making the decision to remover or not. (Ie see how it looks in 3 or 6 months) Like I said, sometimes they go away on their own
Any specific questions?
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Hi Marie,
Thanks for the information on PASH. I was able to see the pathology report last night. Here's what it says
BREAST, RIGHT, 10 O'CLOCK, FOR CALCIFICATIONS, (STOPLIGHT CLIP),
STEREOTACTIC CORE NEEDLE BIOPSY:
- BENIGN BREAST PARENCHYMA WITH FIBROCYSTIC CHANGES SHOWING USUAL TYPE
DUCTAL
HYPERPLASIA AND ABUNDANT ASSOCIATED MICROCALCIFICATIONS.
- PSEUDOANGIOMATOUS STROMAL HYPERPLASIA (PASH) IS ALSO NOTED.
- NO ATYPIA OR MALIGNANCY IS IDENTIFIED.I'm confused because there's no mention of how large the PASH is so how would the breast specialist be able to determine what the best course would be? I called this morning to make an appointment and the she had a cancellation for tomorrow afternoon so I'm seeing her then. I was hoping for a little bit of a respite from my breast!
I
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That is a GREAT pathology report!!!
(and I bet the changes that you are seeing are related to your going thru menopause. IE hormones!!!) You wouldn't get a size of how big the area is on a stereotactic cord needle biopsy report because that type of biopsy are just samples of at the area. If you had an excisional biopsy (i.e. removed of the area) you would get demeantions.
SO hang tight!!
Write your questions down for the Dr.
Seriously, that is a good report. Typical changes for a woman your 54 going thru menopause
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Hi everyone,
I seems we have a twist in the plot.
Originally, I was supposed to have one area (10 o'clock) biopsied for microcalcs. Their recommendation for the second area (9 o'clock) of microcalcs was to recheck in 6 months. While I was getting prepped for the biopsy, I asked the nurses if I could have both areas biopsied rather than wait with the uncertainty for 6 months. They said I could so they biopsied both.
When the nurse called on Wednesday with the results, she told me the pathology report showed no evidence of malignancy but I had two benign conditions (usual ductal hyperplasia and PASH) and so the pathologist was recommending I see a breast specialist. No mention of anything else. I read through the report quickly, made my list of questions and headed to the appointment with the breast surgeon on Friday. To my surprise, she tells me that the two conditions she wants to talk about aren't UDH or PASH, but two conditions in the 9 o'clock area (which I wasn't even supposed to have biopsied). I have a "benign radial sclerosing lesion" and a "benign minute intraductal papilloma." She tells me that while both are benign conditions, they can hide malignant cells so she recommends an outpatient procedure to remove them. She says that 10-15% have malignancies associated with them. I think she saw the shocked look on my face and said "this is not a life threatening event. Your report shows no atypia. The odds are low that it will come back malignant. If it does, both are very small."
I left there with my head spinning. Thought we were out of the woods, now it turns out there's still a risk of malignancy. I'm scheduled for the procedure on February 23rd with a meeting a week later for results. I'm going to post on the benign conditions forum but any thoughts would be appreciated.
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Flamom,
As women, we are always at risk for breast cancer, and that increases as we get older. Always. That will never go away.
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