Microcalcifications - Get biopsies re-checked!

Options
AgathaFran
AgathaFran Member Posts: 8
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

Hi everyone,

I should be feeling overjoyed having recently been told, at my post MX followup, that nothing was found in my final path. and I need no further treatment. Instead I'm feeling confused and angry. Seems my multi-focal, "large area of DCIS" was a removed within that one core biopsy (max 4mm square)??? The very same biopsy which gave my preliminary diagnosis, leading me (my decision) to opt for a UMX and being told I needed a SNB. The other two areas of microcals not core biopsied were obviously B9 and 'not the same' as I was originally told. I just can't quite shake the feeling however, that something is just not quite right about all this.

I realise this is a sensitive topic for those of you battling breast cancer on a dialy basis and yes I do get that I am very fortunate not to have cancer now.  After much reflection I have decided to post some of my experience to alert others who may find themselves in a similar position now or in the future..... Please get biopsies for micro-calcs re-checked before proceeding to surgery. Hindsight is always 20/20 and I wish I could have read something like this three weeks ago when my gut was sceaming at me.  See it for what it is 'a heads up'.  xx

· Share on FacebookShare on Twitter

Comments

  • lane4
    lane4 Member Posts: 175
    edited July 2011

    Thank you for sharing your experience with others -- you are so right about hindsight always being 20/20!  I am so sorry that you were misled by your core biopsy report. Did you have a pre-op MRI? Thankfully, I did and was told by the surgeon that the DCIS was not extensive. However, the partial mastectomy I had was extensive and left my breast a cup size smaller than the other.  There was more DCIS in the final pathology report, but I would have been extremely angry if I learned the core biopsy removed it all after having so much tissue removed.  I can imagine how you are feeling now.  DCIS can really mess with your mind -- you feel like you should be grateful, yet you now have to live with the same body changing issues that someone with invasive cancer does. I, myself, have not had a good attitude about all of this (and I feel guilty about my attitude), then I read that some DCIS never does progress. So the surgery and radiation may have been for nothing? I have declined tamoxifen, as I suspect I may have been overtreated. Again, I know I should be grateful, but it still sucks, nonetheless.

    · Share on FacebookShare on Twitter
  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2011

    AgathaFan- Not sure if you'll check back here but I wanted to thank you for posting.  Not for me as it's too late (NSM 3/10) but for the next one that comes along.  There's a lot of controversy out there about the possible over treatment of DCIS and your story shows why.  It never occurred to me to have my biopsy rechecked but great advice for the newly diagnosed.  Personally, I've learned through this whole experience to not take anything any of my doctors say at face value.  Now I question and research everything and have learned to be my own advocate.  Hopefully, by reading your thread, the next one will learn ahead of time that this is something she needs to do before deciding on surgery.  Thank you!

    · Share on FacebookShare on Twitter
  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2011

    BCO just posted a link to this very same issue- Getting a Second Opinion-

    http://www.breastcancer.org/treatment/second_opinion/ 

    · Share on FacebookShare on Twitter
  • cycle-path
    cycle-path Member Posts: 1,502
    edited July 2011

    As I've posted elsewhere, I think a lot of doctors like to do a "belt and suspenders" approach. They are determined to hit this cancer with everything they've got, and I think it sometimes results in over-treatment. 

    I'm very sorry you were one of these!  

    · Share on FacebookShare on Twitter
  • mom3band1g
    mom3band1g Member Posts: 817
    edited July 2011

    Your story is why I requested a second opinion on every procedure I had. My Dad had pointed out that we were making some very big decisions based on one persons findings. My insurance paid for a second opinion after my biopsy, lumpectomy,and mast w/ snb. Made me feel a little better but not much. OP,I would be furious and am so sorry for what happened to you.

    · Share on FacebookShare on Twitter
  • AgathaFran
    AgathaFran Member Posts: 8
    edited July 2011

    My radiologist told me this too:-

    http://www.healthcentral.com/breast-cancer/c/question/962268/64159

    i.e when you have multiple clusters of the same pattern then whatever is found in one will be found in the others. If this is 'safe to say' then why did that not happen in my case. I am now facing an appalling vista and I can't stop thinking that they were all the same, B9.

    So I am going to add here that not only should you think about having your biopsies for microcalcs re-checked but you might also want to consider a separate biopsy for each cluster. 

    Many thanks for all your kind thoughts and yes I will be seeking answers from my breast clinic. xx

    · Share on FacebookShare on Twitter
  • Eema
    Eema Member Posts: 493
    edited July 2011

    There is a lot of discussion about how to treat DCIS, and I think many times the agressivness of the surgeon depends on the patients age.  The women I've met under 50 opt for mx (umx or bmx) and the women over 70 opt for breast conserving approaches.  I believe the majority of the age base of the doctors' patients will determine the approach--ie, if he/she has a lot of 'older' patients, he/she will recommend breast conserving, while if the population is younger, they recommend mx.  Take a look at the waiting room--I'm guessing who you see determines at least part of the approach to cancer the doctor will take.

    Of course, this is all anecdotal and I'm not an MD, nor do I play one on TV.

    · Share on FacebookShare on Twitter
  • rn4babies
    rn4babies Member Posts: 409
    edited July 2011

    I just questioned my surgeon about that. I had an area of microcalcs bx'd in December that had the same exact characteristics as the area I had bx'd last week. (small cluster of polymorphic microcalcs). The first bx was benign (PASH with fibrocystic changes) and the new one is DCIS. Go figure. He didn't have an explanation.

    · Share on FacebookShare on Twitter
  • cycle-path
    cycle-path Member Posts: 1,502
    edited July 2011

    bump

    · Share on FacebookShare on Twitter
  • DeeLJ
    DeeLJ Member Posts: 182
    edited July 2011

    this is a good thread.

    I had ADH diagnosed with my stereotactic biopsy. My surgical biopsy returned diagnosis of DCIS with no ADH anywhere. They were kind of stumped, having expected to find some ADH at least...which has made me wonder if they misread the FIRST one, (the one that said ADH). I had the slides re-examined and the second read on the surgical biopsy tissue also said DCIS.

    I guess your point goes both ways; not only is it possible for them to misread benign for malignant, they can also misread malignant for benign...

    · Share on FacebookShare on Twitter
  • AgathaFran
    AgathaFran Member Posts: 8
    edited August 2011

    I received the histopathology of my MX right breast back today (waiting 5 weeks) so I thought I would update. This is a breakdown of the areas I thought relevant. The microscopic examination of 14 slices revealed "widespread foci of fibrocystc disease with a few focal areas of ususal ductal hyperplasia" it goes on to say "there is no microcalcifications".  So I'm scratching my head here asking myself what happened to the two areas of microcalcs. which showed on mammo but not biopsied, where did they go?

     "A single focus of ALH approximately 2mm long is present" (my BS never mentioned this at the post MX meeting) but "no residual ductual carcinoma in situ is seen. There are numerous dilated ducts containing secretions. Focal areas of sclerosing adenosis, apocrine change and cystic dilation of ducts are present."  Doesn't sound healthy?

    One part of the report I can't get my head around is the bit where it states "there are focal areas of foreign body giant cell reaction to ?suture material". I have never had any sutures in my breast pre mx. so quite confused about that. The final path. has left me more confused than ever but two months on I am very happy to be feeling so well. xx

    · Share on FacebookShare on Twitter
  • Emaline
    Emaline Member Posts: 492
    edited August 2011

    Oh I am sorry this happened to you. You are the 2nd I have heard of, I read something similar not that long ago.  I did have a 2nd opinion and my biopsy was reviewed by two different teams. My doctor actually did want to do a lumpectomy, as he thought he could get it all...however he was overruled by the tumor board.  He did make a point of telling me that they found a small amount of more cancer in the same area, but since they didn't get clear margins at the excisional biopsy, they were expecting that.  I think he was, nicely...kind of..saying he was right and a lumpectomy would have worked.

    · Share on FacebookShare on Twitter

Categories