Calc on a mammorgram but no biopsy?

Kitchenwitch

Anyone ever heard of anything like this? A family friend, age 49 or so, had a mammo a couple of years ago with some area of calc. (Not sure how big, probably pretty small.) She was told to come back in six months for another mammo. So she did, and they said, "There's been no change. Keep coming back every six months for screenings." 

And that's what she's doing. She lives in a small college town in Massachusetts so med. care is probably OK. 

I guess I want to know, what are the reasons someone would be told to just have active surveillance, and other people are sent right for biopsy/lumpectomy and the whole rest of the road we're on?

 

lisa-e

The radologist who read my mammogram said that the appearance of the calcifications is important. Some calcifications (linear - on my mammo they looked like a feather) are associated with dcis and other calcifications (typically rounded and not organized in a pattern) are generally benign.

Beesie

Calcifications are very common - about 50% - 60% of women get them.  Well over 90% of calcifications are completely harmless.  "Concerning" calcifications are very small (microcalcifications) and are either in a linear formation or are clustered.  Calcifications that fit this description require a biopsy in order to determine if they are benign, pre-cancerous (ADH or ALH, for example) or if they are cancerous (DCIS or IDC).  80% of the time, they turn out to be benign.  Other calcifications - those that are larger, those that are randomly scattered or isolated calcifications, etc., do not require a biopsy because it is almost certain that they are benign. These other calcs are monitored, however, just to ensure that new calcs don't develop which suddenly change the pattern to something suspicious.

What this all means is that the active surveillance that your friend is getting is actually the more common approach to calcifications, versus what those of us with suspicious calcifications have to go through.

Kitchenwitch

Lisa & Beesie - thanks for the info. I felt my friend is probably OK, i just wondered how they make their distinctions. It's good to know there was a reason for my biopsy (besides the obvious one of it being positive for DCIS). Thanks for sharing all your knowledge & research.