Microcalcifications

shazelwo

Hello,

I just left my 6 month check up and will need another biopsy She said the microcalcifications increased in number and clustered to 6 oclock. I had a pash tumor removed at 7 o clock 6 months ago. she said the microcalcifications are in the lobules? Are they always in they lobules? i didnt get a birads score from her since i forgot to ask but i should have the report available online in a few days. Just looking for similar circumstances and outcomes.

shazelwo

Not that anyone is paying attention but for anyone who finds themselves here the same way I did , my biopsy is scheduled for 11/13 @12:30. I'll update again after she said she will give me a preliminary (she will look under the microscope right away) so I have a better idea of what pathology might say. Guess I'll hold my breath until then. My last biopsy was so painful, I developed a very painful hematoma that lasted almost a month We will do an ultrasound guided needle biopsy for the microcals and she said she will biposy another spot but didnt say what procedure it is birads 4c.

cive

Shazelwo, micro calcifications can be in the ducts or lobules.  Since you are scheduled for a biopsy, likely you had a birads 4, since lower birads score don't result in a biopsy.  Even with a birads 4, you have a 70% chance of them being benign.  I hope this biopsy will be easy, most are.  It is too bad you had such trouble last time.  Let us know how it turns out.

shazelwo

INDINGS: 
 Standard images of both breasts in the CC and MLO projections using 
 tomosynthesis were performed. Magnification views of the 
 calcifications in the right breast were performed and compared to 
 previous magnification views as well. 

 The breasts are heterogeneously dense, which may obscure small 
 masses. The parenchymal pattern on the left is stable. Scattered 
 benign calcifications are noted throughout the left breast. 

 No suspicious masses, areas of architectural distortion or suspicious 
 microcalcifications are identified in the left breast. 

 A biopsy clip is noted in the lower outer right breast where the 
 patient underwent a previous benign biopsy performed by Dr. McCroskey. 
 No suspicious abnormalities detected in this area on the mammogram. 

 Nonspecific dense tissue is noted in the area of palpable concern in 
 the upper right breast at approximately 12:00 and a few lymph nodes 
 are noted in the general area of palpable concern in the right axilla 
 but they do not have a suspicious appearance. 

 Generalized density is noted in the central and inferior right breast 
 where calcifications are present. The calcifications have increased in 
 number when compared to the prior examination. This area of the right 
 breast was subsequently evaluated with ultrasonography and will be 
 described below. 

 A targeted right breast ultrasound was performed with attention to the 
areas of palpable concern, the area that was previously biopsied at 
 7:00 and the inferior right breast in the location of generalized 
 density include an increasing calcifications. 

 Currently in the right breast at 7:00, 6 cm from the nipple, multiple 
 cysts or possibly dilated ducts which appear to contain calcifications 
 are noted. This corresponds to the increased generalized density and 
 increasing calcifications on the mammogram. This spans up to 5 cm in 
 its greatest dimension. While its possible that this could represent 
 fibrocystic change with multiple calcifications, the possibility of 
 dilated ducts containing calcifications consistent with DCIS cannot 
 entirely be excluded and further evaluation with an ultrasound-guided 
 breast biopsy using vacuum assistance is recommended. It is also 
 recommended that the core samples be radiographed to ensure that 
 representative calcifications are present in the sample. 

 A round hypoechoic nodule measuring up to 4.2 cm is noted in the 
 posterior aspect of the right breast at 10:30, 4 cm from the nipple 
 which may represent a complex cyst or solid mass. Further evaluation 
 with an attempted aspiration followed by core biopsy, if it will not 
 aspirate is recommended in further assessment. 

 In the area of palpable concern in the upper right breast at 12:00, 
 benign-appearing tissue was noted at real-time. No suspicious 
 ultrasonographic abnormalities were identified in the area of palpable 
 concern in the right breast at 12:00 at real-time. 

 In the area of palpable concern in the right axilla, multiple 
 morphologically benign-appearing right axillary lymph nodes are noted 
 with echogenic hila and non-thickened cortices. A note is made that no 
 suspicious right axillary lymph nodes are identified. 

 IMPRESSION: 

 1. There is no mammographic evidence to suggest the presence of 
 malignancy in the left breast at this time. 
 2. There is increasing number of microcalcifications associated with 
 generalized density in the inferior right breast with corresponding 
 cystic change containing calcifications detected at ultrasonography at 
 7:00, 6 cm from the nipple. Further evaluation with an 
 ultrasound-guided breast biopsy using vacuum assistance and with a 
 specimen radiograph of the core samples for verification that 
 representative calcifications were retrieved is recommended. 
 3. Low suspicion nodule in the right breast at 10:30 for which further 
evaluation with a cyst aspiration and possible core biopsy is         recommended.        
 BIRADS CATEGORY 4: SUSPICIOUS - Biopsy should be performed in the      
  absence of clinical contraindication - 4B (Moderate suspicion for malignancy)       
  A right ultrasound-guided breast biopsy x 2 is recommended.       

shazelwo

Also I thought it was category 4c I am pleased to see that it is actually a 4b! Any thoughts on this report , it is SO LONG.

cive

So have you had the biopsy yet?

shazelwo

No, it is scheduled for Monday 11/13 @ 12:30, thank you for checking in it really means a lot to me. I am wondering if what they are seeing could be scar tissue from the hematoma, but cant seem to figure out if that would create microcalcs. Ive seen a lot of literature where it can create just calcifications but nothing on it creating microcalcs. it IS in a very close vacinity and honestly I cant tell for sure but might even be that exact spot.

MTwoman

shazelwo, an injury or even inflammation can cause microcalcs, so it is possible that an area that had a hematoma could have developed associated b9 microcalc. I'm sending positive thoughts for that to be the case for you!

shazelwo

Alright!! That is great to hear, thanks MTwoman. I bet that is what it is.

MTwoman

shazelwo

Just got done with my biopsy. She explained that she simply chose a target because the area is very large, spans through 5,6, and 7 o'clock. She gave lidocaine with epinephrine because there was blood flow she wanted to "put to sleep" through the procedure, I thought that was pretty neat that they can do that. She didn't say much other than she would write a note to the pathologist and that it might take a week to know for sure what this is. Procedure was completely pain free and she took several samples across the path of the "thing". I have a terrible headache ,

shazelwo

Also something I read on here got me through alot of the fear of pain today they said " you dont have to be brave you just have to show up" that was SO helpful for me.

cive

Let us know about your results when you get them!

shazelwo

So I got my pathology report it says:

- Fibrocystic changes including duct ectasia, apocrine metaplasia with micro cyst formation, stromal fibrosis.

- Sclerosing adenosis, focal.

- No cytologic atypia or malignant process identified

So Yay! I retrieved this off of labcorp patient portal since I was told on Thursday and Friday they didnt have the results even though I got an email stating it was recieved at my Dr office on Thursday (from labcorp). So Im guessing I will speak with my Dr next week about these results and likely jump back on the 6 month watch and wait train. Dr. Google has given conflicting information about sclerosing adenosis so Im not sure what to think about that in the sense of I am unsure if they will want to remove it even though it is totally benign it is rather large. If anything changes I will update the thread again but I highly suspect this can be put to rest for 6 months.

MelissaDallas

shazelwo, I was told the scerosing adenosis was nothing to worry about

cive

shazelwo,