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Topic: Birads3 - grouped microcalcifications

Forum: Not Diagnosed But Worried —

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Posted on: Oct 28, 2019 08:11PM - edited Oct 29, 2019 10:08AM by Rsin

Rsin wrote:

Hi everyone

I am 40 with no family history. Went for my first screening mammo and was asked to come back for a diagnostic on right breast. Left breast had benign findings - scattered microcalcifications. Diagnostic mammogram on right breast showed a group of round microcalcifications over 2cm area and was reported as BI-RADS 3. I am very worriedand planning to get second opinion and even a biopsy. My PCP thinks it's nothing to worry about and just do the follow up in 6 months.

sorry for the long post. I really Appreciate any inputs I can receive here. Thank you so much.

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Oct 28, 2019 08:54PM Beesie wrote:

A BIRADs 3 means the Radiologist assesses less than a 2% chance of cancer.

Round calcifications are more likely to be benign. The fact that they are clustered is probably what is bumping you up from a BIRADs 2 to a BIRADs 3, but with the calcs being over a 2 cm area, it suggests that this is not a tight cluster, so again that leans towards benign.

Normal follow-up for a BIRADs 3 is imaging in 6 months. The purpose of the follow-up is to assess stability, in which case a biopsy can be avoided. I've had lots of BIRADs 4s and lot of BIRADs 3s, and I've always been happy to get the 3s so that I could avoid a biopsy. None of my BIRADs 3 have ever required a biopsy upon follow-up.

If you are uncomfortable, a second opinion on your imaging will be helpful. If the assessment is the same, you can feel better about the recommendation to follow-up in 6 months. If the assessment is different, you can proceed with a biopsy now.


“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Oct 29, 2019 12:08AM Rsin wrote:

thank you Beesie for your response. I will move forward with getting second opinion.

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Oct 29, 2019 06:58AM - edited Oct 29, 2019 07:00AM by DATNY

I did have that. Followed it for two years and they were stable. Than a year later, my annual screening found multiple tumors (at other places, but same breast) including one in a lymph node. So my conclusion was they were some sort of warning sign in my case. In general, calcifications appear because there are processes taking place at a faster rate than they should be.

I regreted not doing a biopsy initially. Not sure it is possible with Brads 3 , I never asked.

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Oct 29, 2019 08:07AM djmammo wrote:

DATNY

"In general, calcifications appear because there are processes taking place at a faster rate than they should be."

Can you direct me to a reference for this? Thanks.

Board Certified Diagnostic Radiologist specializing in Breast Imaging helping members understand their health care provider's reports and recommendations.
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Oct 29, 2019 10:14AM - edited Nov 6, 2019 06:22PM by Rsin

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Nov 6, 2019 06:22PM Rsin wrote:

It is taking forever to get a second opinion and the waiting is not helping my anxiety.

DjMammo, will you be able to offer any kind of insight on why the type of calcifications I have are probably benign and not totally benign. Are they lobular? Does DCIS look like this as well? What are the chances of this turning invasive (if malignant) during the 6 month waiting period?

From Report -

CLINICAL HISTORY: Callback.

BREAST DENSITY: The breasts are heterogeneously dense, which may obscure small masses.

RIGHT BREAST DIGITAL MAMMOGRAPHY FINDINGS: 2 cm area of grouped round calcifications seen within the 7:00 location of the right breast 6 cm from the nipple. These calcifications have a probably benign appearance.

IMPRESSION: BI-RADS Category 3-Probably Benign Findings.

RECOMMENDATION: Six-month follow up is recommended. Right diagnostic mammogram in six months with magnification views recommended.

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Nov 6, 2019 11:28PM djmammo wrote:

Rsingh1

Grouped round calcifications have a higher probability of being benign than other shapes (and grouped is better than clustered).

Classically, DCIS is described as "linear branching" calcifications.

B3 indicates a 98% chance they are benign

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Board Certified Diagnostic Radiologist specializing in Breast Imaging helping members understand their health care provider's reports and recommendations.
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Nov 7, 2019 08:39AM Rsin wrote:

DJMammo - Very much appreciate your quick response. Thank you!

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Nov 20, 2019 01:46PM Rsin wrote:

djmammo

I decided to move forward with a biopsy and not wait in anxiety for another 6 months. The results came back benign. I am yet to go over the results with my breast surgeon. Here is the final diagnosis. Can you please help me understand the report. Are any of these re risk factors for breast cancer?

From the report-

Negative for malignancy.

Proliferative fibrocystic change.

Pseudoangiomatous stromal hyperplasia.

Small Intraducal papilloma

Columnar cell change with hyperplasia.

Calcifications identified.

Thank you again for your time and help.




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Nov 20, 2019 01:54PM djmammo wrote:

Rsin

Negative for malignancy. - Great!

Proliferative fibrocystic change - benign

Pseudoangiomatous stromal hyperplasia - PASH

Small Intraducal papilloma - if the entire papilloma is not completely included in the specimen, it will have to be removed

Columnar cell change with hyperplasia - see this explanation: https://breast-cancer.ca/clmncellesions/

Calcifications identified - must be benign type calcs


Board Certified Diagnostic Radiologist specializing in Breast Imaging helping members understand their health care provider's reports and recommendations.
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Nov 20, 2019 02:43PM - edited Nov 20, 2019 05:21PM by Rsin

This Post was deleted by Rsin.

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