BI RAD score of 4 and 5, microcalicifications, and lumps

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ella23
ella23 Member Posts: 36
edited March 2016 in Waiting for Test Results

**disclaimer: apologies in advance for any misuse of terminology.  I'm very new to all this.

I recently found a lump in my breast and went in for a diagnostic mammo.  Mammo and ultrasound found 3cm mass in right breast (BI RAD 4) and 1 cm mass + microcalcifications in left breast (BI RAD 5).  Radiologist showed me the films and explained that the pattern of microcalcifications in the left breast is textbook DCIS.  Biopsy results pending.  I understand that no official diagnosis is possible without a biopsy.

1) What does all this mean (BI RAD score of 5, plus what radiologist said)?  Does it mean that worst case scenario, the biopsy will confirm that the left breast is "just DCIS" and not  invasive cancer?  Or is there a chance that it could be worse than DCIS?  Radiologist also said that there was no evidence at the moment that any cancer has spread into other areas in/near breasts.

2) Radiologist said one way or another, an MRI is likely and surgery to remove microcalcifications on L side is inevitable.  Any thoughts on this?

I'm trying to prepare myself for realistic best case / worst case scenario.  Any help or advice would be great.  I'm not yet 40 but have BC in the family. Thanks so much.

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  • dtad
    dtad Member Posts: 2,323
    edited March 2016

    So sorry you have to be here but welcome. I know you will find this forum very helpful. Try to stay away from Google during the diagnostic stage. Let me just say that this time is the worst of the journey. The unknown is so scary and our minds tend to wonder. The reality is almost always better than we think! Try to remember they have to prove you have breast cancer before you do. IMO a MRI is the appropriate next step and is really the only tool that will give you the whole picture. That being said please keep in mind you can get false positives that may lead to more biopsies. So don't panic if that happens. Please feel free to private message me if you want to talk more details. Good luck and keep us posted...

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  • ella23
    ella23 Member Posts: 36
    edited March 2016

    Thank you, dtad.  Waiting truly is the worst.  I'm trying to do my best to prepare, not just my heart, but also prepare practically and do as much research as I can before I start seeing more docs.  I know that BI RAD 5 is not good news but just trying to decipher if I should brace myself for DCIS or something worse....

    I need a huge block of dark chocolate right now in the worst way. 

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  • Seedsally
    Seedsally Member Posts: 260
    edited March 2016

    Talitha first let me say sorry for what you are going through. I understand as I am on that same road. My diagnostic mammo and ultrasound combined everything on basically one report. I was BiRad 5 and have had a needle biopsy of right breast which turned out to be IDC and stereotactic biopsy if left that shows atypical Ductal hyperplasia. I am now scheduled for surgical biopsy to excise the tissues in left breast and further evaluation of the findings before scheduling surgery on right breast. I actually felt better after the results started coming in because I had already accepted BC as the probable DX That doesn't mean I don't feel panic and shock because I do but I am trying not to make hasty decisions My mind is all over the place right now but as one member advised I am just trying to breathe and calm myself. I hope you get better results and please keep us informed

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  • april485
    april485 Member Posts: 3,257
    edited March 2016

    BIRAD score of 4 means further exploration through biopsy recommended. BIRAD score of 5 means malignancy suspected (but not a definite although more likely) and a biopsy is the least you should do. After the results come back from your biopsies, then and only then will you know what you are dealing with. Sounds like your radiologist is confident it is very early and even more, feels it is stage 0, but they cannot be sure what you are dealing with until after biopsy results. Hang in there and don't panic. You have to wait which is the worst part to know, but we are here no matter what you end up being diagnosed with. Yes, it could be more than DCIS but the radiologist feels that DCIS is what you are dealing with.

    The MRI is most likely recommended because of your age and the fact that younger women have denser breasts so they need to get a better look than mammography can usually give them.

    Hang in there! And most definitely you deserve that chocolate

    Winking

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  • ella23
    ella23 Member Posts: 36
    edited March 2016

    thanks, seedsally and april. I barely slept a wink last night and am battling an awful cold + migraines while waiting for my results. I can't get myself to stop researching symptoms, diagnoses, treatment options, etc. My biopsy results come in Wednesday and I'm considering just camping out at my dr's office until then. Ugh, I hate this.

    One question for you ladies: assuming biopsies come back positive, what's the next step? Which doc(s) do I need to start setting up consults with?

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  • hopeful23
    hopeful23 Member Posts: 35
    edited March 2016

    talitha,

    Assuming you need further treatment after your biopsy results (and you may not!) the next step would likely be to find a surgeon you feel confident in. There is no rush, but it might be less troubling while waiting to research surgeons rather than googling symptoms and diagnoses. You will want a surgeon whose speciality is breast cancer surgery. I was fortunate to have a comprehensive cancer center near me and, although I felt sure I would select a surgeon at their breast center, I still went to a second surgeon (who was also wonderful)at another breast center for their opinion. I liked being able to visit with two surgeons since I learned a lot from them both. The breast center took care of everything from there. They helped me schedule a date for surgery and also set up any other appointments I needed. Best wishes to you, Pam

    Here is a link to find comprehensive cancer centers http://www.cancer.gov/research/nci-role/cancer-centers

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited March 2016

    I am so glad I'm finally past the stage you're at. Tossing and turning, reading and reading, worrying and waiting was by far the worst part of my whole ordeal so far. I am so glad I found this forum. The only thing besides this forum I have found that has helped me to regain my sanity is walking. Getting out every day and walking, watching Spring starting, watching water running in the river and not looking at a computer screen and of course praying. I'm sending you good thoughts.

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  • ella23
    ella23 Member Posts: 36
    edited March 2016

    Hopeful, I took your advice and researched surgeons in my area last night at 3am. Because I'm Type A I called them first thing this morning and was told by both offices to basically chill out and wait until biopsy comes back before trying to schedule anything. So I took their advice and did some retail therapy this afternoon. I felt a bit better. But seriously, THIS WAIT....

    Stacey, I'm glad to be reminded that in many ways, this waiting game is the worst part of this journey. Wish I lived near a river that I could sit by when I feel like I'm going crazy! A much better option than retail therapy.

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  • ella23
    ella23 Member Posts: 36
    edited March 2016

    just got the call from my dr--IDC in both breasts. I'm devastated and in disbelief.

    Stacey, being recently diagnosed yourself (I think?) do you mind if I ask if chemo is in your future? My doc implied that it was for me but I don't understand how she would be so sure.

    I'm terrified...I'm 38 and am a relatively new mom....

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  • april485
    april485 Member Posts: 3,257
    edited March 2016

    ella, your relatively very young age and the fact that your cancer is bilateral almost assures you will be told you need/should have chemo. I know you are terrified. BC scares everyone and most especially those of you that are young with small children. I wish you the best and just know that many women are diagnosed, treated and live a long life. Hold on to that. Hugs and prayers coming your way.

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  • dtad
    dtad Member Posts: 2,323
    edited March 2016

    Im so sorry Ella. I promise when you know more facts and get your treatment plan in place you will feel better. Please feel free tp private message me if you want to talk more details. Good luck and keep us posted....

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited March 2016

    Ella, it actually does NOT look like chemo is in my future :) I also do not have to have radiation. I attribute it to the prayers of many good people, as well as some herbal supplements. Things did not look so great going in - when all of this started they found two lumps, one of which was 3.5cm and an 8cm line of microcalcifications. By the time I had my MRI I only had one lump and 4.5cm "non-mass enhancement". When I had my bilateral mastectomy, the cancer turned out to be much smaller than they thought it was. I only had one lump which was 1.9cm in diameter. None of the microcalcifications were DCIS, the large "suspicious looking" area on the MRI turned out to be nothing at all, with the two biopsy clips in it, and the breast I had prophylactically removed was 100% disease free.

    Don't discount the power of prayer and supplements :) May your news be as good as mine was.

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  • ella23
    ella23 Member Posts: 36
    edited March 2016

    thank you April, dtad and Stacey for your responses. Stacey, so awesome to hear your good news..thank you for sharing. :)

    I'm so overwhelmed right now...researching breast surgeons has been a nightmare. I've narrowed my list down to three options based on my research online and people's recommendations (mostly strangers) but I feel so much pressure to make the right choice when it's just not clear to me who would be right.

    How were you able to select your surgeons/team?

    I'm terrified of the real possibility of a BMX and chemo, with all its effects. I've seen way too many photos of reconstruction gone bad. I want to be able to continue with my work, which requires a lot of international travel. I'm overwhelmed with insurance-related matters. I dread having to tell my family about my BC. I don't trust I will deal with offensive yet well-meaning comments with grace. I worry about how my 3 yr old will handle what's to come. I worry I won't be able to "fake it" when I need to the most.

    It's all so much. I hate being dramatic but I feel like that's what I'm doing and it makes me even more frustrated with all this.

    Thank you for letting me vent. I'm grateful for this safe space.

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  • april485
    april485 Member Posts: 3,257
    edited March 2016

    Hi ella,

    I also agree with StaceySue..don't discount the power of prayer and of any force for that matter. One never knows! There is always hope. As for how I chose my team, it was a no brainer for me. I went to the only NCI designated Cancer Center in my state of CT, Yale and chose my team from among the best there. It was a good choice all around. I was and am confident in all of them. I also am blessed to be sandwiched in a state between New York (Memorial Sloane Kettering and other great hospitals) and Mass. (Dana Farber, Mass General etc.) so if I did not like my team, I did have options out of state.

    If you live close to TX border at all, or have the means and energy to do so, the number one Cancer Hospital in the US is there. MD Anderson. But, there are likely many good options in AZ as well.

    Best to you. It will all work out in the end. Hugs!

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  • dtad
    dtad Member Posts: 2,323
    edited March 2016

    Hi Ella. IMO you first should chose a university based teaching hospital to be treated at. Then look at the list of breast surgeons. I would recommend a surgeon that specializes in breast surgery not a general surgeon. Then you can look up any doc on sites that rate them. Just google the docs name plus reviews and the sites will come up. Good luck. I would be happy to help if you need it...PS Also agree about MD Anderson

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  • april485
    april485 Member Posts: 3,257
    edited March 2016

    dtad, thanks for adding this most important information about it being a surgeon who specializes in breasts!

    ThumbsUp

    That is an extremely important piece of this. I agree completely and made sure that is who I used for my surgeries.

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  • Beatmon
    Beatmon Member Posts: 1,562
    edited March 2016

    Ella23, I know there are ladies from Arizona on these boards. Maybe you could post a question for them on another post just headlined for them. I know for sure there are some really nice ones because I've personally met them at a TaTa reunion. They may have some good recommendations.

    You may see an oncologist first prior to any surgery.

    Please stay in touch and let us know how you are doing.

    Brenda E


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