ALH and microcalcifications Question...

It is common that they will find more ALH (it is usually multifocal- meaning there are commonly multiple spots of it in one breast - and it is often bilateral - in both breasts) http://www.ncbi.nlm.nih.gov/pubmed/9788628, but if you have multiple spots of ALH that does NOT mean that you will have any higher risk of breast cancer than what you have now with one known spot of ALH.  Since many spots of ALH and/or LCIS are ONLY picked up as an incidental finding at biopsy, and they cannot biopsy your entire breast without a mastectomy, most women with ALH or LCIS will have multiple spots.  Most cases of subsequent breast cancer that ALH or LCIS women get will NOT be at the site of known ALH or LCIS.    ALH/LCIS is a weird condition. 

Again in about 80% of biopsies, they will NOT upgrade you to anything worse than what you already have.

Breast pain in stereotactic biopsies is very subjective.  I have had tolerable stereotatic biopsies and one that wasn't.  Our pain perception is highly colored by our past experiences and expectations.  Whatever experience you have will be valid.  If you are concerned, then tell the doc you are concerned about pain, and ask the doc to give you plenty of anesthetic (before the procedure starts.)