radiologist vs. oncology surgeon...

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shabby6485
shabby6485 Member Posts: 679
edited June 2014 in High Risk for Breast Cancer

Hi everyone,

long history of b9 calcifications and adl.  just got back on yearly mammos after the 6 month checks.  lo and behold, two new sets of indiscriminate microcalcs... birads 4.

this is will biopsy 5 and 6 for me.  can't get to one cluster because it's behind nipple so that means surgery.

spoke to my oncology surgeon who said he was "unimpressed" with films and not that concerned. (I assume these surgeons know what they are looking at)

I am confused.  Hate to go back into surgery.  Sleepless and depressed.... thanks for letting me vent... 

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  • Galsal
    Galsal Member Posts: 1,886
    edited February 2012

    so many biopsies...i'd vent too!

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  • djmammo
    djmammo Member Posts: 2,939
    edited February 2012

    Has anyone recommended yearly mammography and yearly MRI off set 6 months from one another? This is often done for women considered "high risk" and may avoid so many biopsies.

    As far as who to believe you need to know if the radiologist does breast imaging exclusively. If s/he doesn't they may be overcalling these calcifications. 

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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2012

    BIRADs 4a, which is how the radiologist rated your films, represents approx. a 10% risk of breast cancer.  It sounds as though the oncology surgeon is rating the films as BIRADs 3, which represents approx. a 2% risk of breast cancer.  So both are saying that it's quite unlikely that this is cancer, but the radiologist is being more conservative and suggesting the biopsy.  That's reasonable but it would also be reasonable to wait a few months - maybe 3 rather than the usual 6? - to see if anything changes.  If no new calcs develop (in a suspicious pattern), that would decrease the odds that this is cancer, since cancer continues to multiply and spread.  

    It all depends on which approach you can live with more easily... another biopsy now or a few months wait and then probably no biopsy will be necessary.  

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  • leaf
    leaf Member Posts: 8,188
    edited February 2012

    Hi shabby!  I had an ultrasound-guided core biopsy directly under my nipple.  It turned out to be 'consistent with scar tissue'.  (I have LCIS and ALH and nothing worse.)

    Some LCIS women have MRI alternating with mammo every 6 months. I was told no MRI because I have too much scar tissue from my one-and-only breast excision (per 2nd opinion).

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited February 2012

    shabby-----since all your previous 4 biopsies for calcs turned out benign and they were 4C , it 's highly likely that these 4A calcs are benign as well. So the radiologist is recommending biopsy (probably just  being very cautious and thorough), you've basically already had a 2nd opinion ( the oncology surgeon saying he wasn't very concerned); but you could take the mammos to an independent radiologist and get a 3rd opinion to see which route he recommends. They may say it's fine to just keep monitoring and recheck in 6 months. Have you ever taken tamoxifen for the ALH?  I am high risk due to LCIS ( the next step above ALH with double the risk) and my mom's history of ILC. I took tamox for 5 years and now have been taking evista for almost 3 years. I haven't had any more issues with calcs  (or otherwise), so I think I have to give credit to the meds, the seem to be working very well for me.

    anne 

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