Are microcalcifications pre cancerous?
I am a two time breast cancer survivor but have been put thru the ringer 2 years in a row with mammogram readings of my remaining breast. I recently had my yearly mammo (Dec) and tech took mammos three separate times, then onto a table facing down for the 4th round of mammos. The radiologist came in for the table mammo and said if he determines there are clustered microcalcifications that a biopsy would be in order. After closer look (table mammo) he determined I would not need a biopsy at this time but that I need a mammogram in 6 months to see if a change has occurred since I had BC in left breast. I have been thru BC twice, the later in 07'. As a result, a mastecomy was performed. I am fearing the microcalcifications may turn into cancer. I've read microcalcifications are sometimes pre cancerous?
Input, opinions appreciated.
Comments
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Microcalcs can be associated with benign or malignant disease. Often if malignant they can represent ductal carcinoma in-situ, which some refer to as "pre-cancerous", but it really is a stage 0 cancer. That may be where you had heard that reference. Mammographers are usually very conservative in deciding when to do 6 month f/u vs. biopsy in someone who has a history of cancer, so it sounds like your news is reassuring. If its possible for you, and would be reassuring, you could always get a "second opinion" reading from another imaging department or breast care center to make sure they agree with waiting instead of biopsy
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Microcalcs can be benign & harmless (that's over 90% of cases), or they can be a sign of a precancerous or high risk condition (for example, atypical ductal hyperplasia or atypical lobular hyperplasia), or they can be a sign of breast cancer (usually DCIS but sometimes invasive cancer).
What the radiologist looks for in examining the mammograph film is the pattern of the microcalcs. Clusters microcalcs and linear microcalcs are the ones that are of concern because these could be ADH/ALH or breast cancer or they could be benign - there is simply no way to know what they are just by looking at the mammogram film. So clustered and linear microcalcs always get biopsied. 80% of the time, they do turn out to be benign. Other microcalcifications, if they are single microcalcs or scattered or in a random pattern, don't need to be biopsied because they don't have the appearance of possible malignancy. However in most cases if you have microcalcs that fit this description you will be called back for a re-check in 6 months. This is so that the radiologist can see if more microcalcs have appeared and if the pattern has changed to something that is more concerning. In most cases after 6 months you are given the "all clear" but in a small number of cases, you might at that point be sent for a biopsy, if the pattern now appears clustered or linear.
I agree with kmmd that if you are uncomfortable with the radiologist's recommendation, the best option is probably to get a 2nd opinion - take your mammo film to a different facility so that it can be read by a different radiologist. If the 2nd radiologist gives the same recommendation (i.e. come back for a re-check in 6 months), you can feel a lot more comfortable. Or perhaps the 2nd radiologist will see something different and recommend a biopsy now.
Hope that helps.
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I can mention what my mom's onc had said 15 + years ago. After her first round of cancer, and treatment was over. She had her followup mammos and calcifications showed up.
At that time, The onc couldn't recommend her get the calicifications removed. He could only offer her the options, wait and see or remove. He repeated the questions several times her, until she got the message. He said he couldn't recommend that, only give the options.
For peace of mind, you might want to get a second opinion, or goto your onc and see what he recommends.
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Here is a good website I came across with a LOT of information on calcifications. Maybe there is some info in it that can help you understand microcalc's better. I had a biopsy back in July '08 and the microcalcifications I had were ALL related to b9 conditions. Here is website:
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I'd get it checked out anyway. I had a biopsy on calcifications that came up first as DCIS, also known as pre-invasive or non-cancerous or stage 0. This was from a stereotactic biopsy, but then during mastectomy turned out to be a tiny invasive lobular cancer.
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momzr (1-8-09) thank you for website -
http://www.radiologyassistant.nl/en/4793bfde0ed53 - it was very helpful.
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