Microcalcifications

gtgirl

I am not sure if this is the right forum to post this in.  I was searching this site for stable microcalcifications and any input.  I have read some posts from Beesie moderator and others.  I had my baseline at age 35 just a few weeks before turning 36.  I received a letter in the mail stating I needed to come back for additional views.  I then was told the Radiologist recommended a biopsy.  I right away made an appointment at The U of M in Ann Arbor Michigan.  It was a second opinion.  I then was told the same, but after the Radiologist talked with my BS and Hematologist, they felt waiting 6 months was ok.  I have had 6 month check ups with no change for two years and I have had yearly check ups the past two years with all stable, no changes.  So, it has been 5 years it will be 5 years in March.  My next mammogram is September.  I have been stressing out worrying "what if I have BC" in this breast?  I was told when I was diagnosed with BC in my left and prior to my surgical biopsy, that my right and left breast ARE different.  My diagnose of BC in my left was microcalcifications.  I have dense breasts.  I am told they aren't concerned about my right breast, but can't say that new calcs will not show up.  So much different information I read.  My goal is to have my right breast removed in the Spring.

marie5890

GtGirl I am a bit confused.

Have you been diagnosed with breast cancer or do you have microcals that they are watching?

If breast cancer, what kind? What grade? what is your hormonal status?

(edited) Ok just read your profile…

gtgirl

It should of been at the bottom of my post, not sure why it didn't show. 

Beesie

gtgirl, when I was diagnosed with breast cancer, I had suspicious calcs in both breasts.  The biopsy of the calcs in my right breast found cancer.  The biopsy of the calcs in my left breast came back benign.  Because I had a lot of DCIS (and a microinvasion of IDC) in my right breast, I had to have a MX.  I had a single MX.  After that, I had a couple of 6 month follow-up mammos to monitor the calcs in my left breast.  They remained stable and now I'm just checked annually.  

So yes, what you were told is 100% correct.  Each breast is different.  About 50% of women develop calcifications and just because you have calcs that turned out to be cancer in your left breast doesn't mean that any calcs that develop in your right breast are cancer too.  That is absolutely not the way it works. 95% of calcs are not cancer, and this is true for you too, even though you've already had calcs that did turn out to be DCIS. In your case, because your right breast calcs have been monitored and found to be stable for 5 years, then it's almost certain that they are not cancer.  And if they aren't cancer, they won't ever become cancer.   Benign calcs don't turn malignant. 

Of course, you could develop new calcs.  Anyone can.  But again, 95% of calcs that develop are not cancer.  Many women on this board who've had DCIS have had calcs develop in the future and have required a biopsy.  Most turn out to be benign, just like mine did. 

If this is worrying you so much, have you talked to your surgeon about having a biopsy done on the calcs in your right breast?  With 5 years of stability, it really doesn't sound like it would be necessary, but if that's what it takes to give you peace of mind, maybe you should discuss it with your surgeon.

gtgirl

Beesie, I am waiting on responses from my BS/NP.  I feel that since my hormone receptors are ER/PR - that I am at a even higher risk for breast cancer in my right breast.  This is just why I want to have my right breast removed.  As I have stated, I have very rare bleeding disorder and this complicates things.  I will be 41 at the end of March, I am young.  I was told recently in my support group that truly made me upset, that most likely I am HER2- meaning TNBC.  I have NEVER been told this by my BS or the Radiation Oncologist (when I spoke to him about my options).  I was told that with DCIS, they don't test for HER2.  Maybe other Hospitals do.  I was not genetically tested either.  I don't know why?  I have one sister 17 months older, neither of us have children and we aren't going to have any.  I had a hysterectomy at age 30 with all my female parts removed. 

Beesie

When women with DCIS look through this board or talk to other women with breast cancer, it's easy to get caught up with things that really don't matter for DCIS.  HER2 status is a big deal for invasive cancer but it's irrelevant for DCIS. 

Some facilities test HER2 status for DCIS, others don't.  Whatever the results, it doesn't matter.  When women with DCIS find out that they are HER2+ (about 40% of DCIS is HER2+ vs. only 20% of invasive cancer being HER2+), they worry however there have been many studies that suggest that there is no difference between HER2+ DCIS and HER2- DCIS in terms of prognosis.  

Same thing with triple negative.  Triple negative is not a term that is relevant to DCIS, because HER2 status doesn't matter. 

As for genetic testing, that's a completely separate process from testing that's done on your pathology and it's certainly not something that is automatically done.  Normally the first step is seeing a genetic counselor to see if your family history suggests that there might be genetic cause for your cancer, and then, if appropriate, the testing is done (a simple blood draw is all that's necessary).  If you are concerned about this, you should ask your doctor for a referral to a genetic counselor.

hoping42

Beesie, you are truly full of knowledge!  Thank you for all that you share!

xo Danielle

gtgirl

Beesie, I don't know if I should see a genetic counselor?  I don't know what that even means or what it would tell me?

Beesie

gtgirl, you commented about genetic testing in your earlier post; I was responding to that. 

You said "I was not genetically tested either. I don't know why?"  

The only person who can determine if genetic testing might be appropriate for you is a genetic counselor.

sabihah

As far as I can tell, most genetic counselors (GC's) have a background in genetics + psychology + nursing, or some similar combination.  If you want genetic testing or if you're concerned that the cancer in your family may be hereditary, you usually go to a GC.  A GC can help you create a "cancer family tree" (technically called a pedigree chart), where you list everyone in your family who has had cancer, what specific type of cancer it was, and at what age they were diagnosed.  They prefer to go back 3 generations if possible, but they'll take what they can get.  Actually, it's best if you can do the legwork to get all of this data before your first GC appointment.  (FYI, GC's can also talk about other diseases that can run in families, not just cancer.)

Using your family tree, the GC will determine if the pattern of cancer in your family seems to indicate that hereditary cancer may run in your family.  If there is a good chance that the cancer in your family is hereditary, they will tell you that you are a good candidate for genetic testing, and they can order the testing for you, if you want to do that.  If the cancer in your family doesn't seem to be hereditary, they will tell you you're not a good candidate for genetic testing.  Sometimes they'll tell you that someone else in your family should be tested, but not you.  It's all a bit complicated, but the GC's job is to explain everything and help you make your own decisions.

There are definite downsides to finding a genetic mutation (like possibly not being able to get life insurance any more), and GC's are trained in talking you through your options so you can make an informed decision.

gtgirl

Beesie, I did comment about genetic counseling.  I have been asked and then told I should have this done by people, not healthcare professionals. 

sabihah, The only "maybe" breast cancer in my family would be my Maternal Grandma who died at age 78 and diagnosed at age 77 with lung cancer Adnocarcinoma.  We were told it was either Breast or Ovarian.  My grandma never had mammograms or pap smears.  My mom feels it was Breast Cancer.  She had no treatment.  This is all that I know. 

,

marie5890

gtgirl,

No need for genetic testing. And older grandmother who passes away possible from BC isn't seen as a possible genetic risk. 1) she was older, which that, along with being female are THE biggest risks 2) she was not first level relation.

You don't have a strong family history.

The 2 biggest risk facts are and still remain, being a woman and getting older.

CTMOM1234

gtgirl, I have learned through this process that micro-calcifications leading to a bc diagnosis in one breast does not mean anything about micro-calcifications indicating bc in the other breast. I know, seems as though there would be a correlation, but the mere presents of micro-calcs in a breast is not problematic...even if the other breast had bc.  Some of us "lucky" women just seem to have dense breasts and micro-calcs, and it is hard to not get worried. 

It's been over 4 years since a routine mammogram when I was only a few years older than you showed a cluster of micro-calcs on my left-side (first time they ever were visible on a mammogram) that resulted in my first-ever biopsy and a bc diagnosis. I have annual diagnostic mammograms now and have seen that my right-side has visibly micro-calcs but no one has ever suggested they should be biopsied. Believe me, I've pumped the radiologists with questions over the years, and not even a Birad 4 or anything to raise a flag... and I am OK with that. 

A wise doctor once told me "Don't go looking for trouble" and I have inner peace. I agree with earlier posters that getting to that point is very important, we all must make the best decisions for ourselves with the information available at the time, second-guessing and regrets can be very destructive, and surgery is a big thing, so take the time to make sure of your feelings. I do believe that information is very important, but am not a fan of undergoing biopsies unless deemed necessary by my doctors (already had a false positive MRI that led to a biopsy and that stress and pain was bad, too).

CTMOM1234

If you decide to undergo genetic testing, you must first consider what you would do with the information. My bs spoke about my having a mastectomy at our very first meeting, and upon my expressing a strong preference, if possible, for a lumpectomy, he sent me for an MRI and genetic testing before "agreeing" to a lumpectomy.  Thankfully all subsequent tests came back fine, but I did have to mentally prepare myself as best as I could, not easy, for various alternative surgical scenarios if I were BRCA1 and/or 2 positive including ovary removal and bmx.