Benign microcalcifications after lumpectomy?

My pre-radiation mammogram almost a year ago showed new microcalcifications. I was stunned. The radiation oncologist consulted with my team and the decision was made to just watch the new area, rather than biopsy. I was comfortable with the decision as I am taking letrozole and I am monitoredwith a mammogram and/or MRI every six months. I had a mammogram in early October and everything was stable. I return in late March for a mammogram and MRI, so they are watching the calcifications closely.

What is your team recommending?

It seems like it's very common to get some calcifications near a breast surgery site, sort of the body's message something happened here. The radiologist told me calcifications related to surgery and the calcifications related to malignancy are similar looking.

What I have been reading so far in my research is that the sooner they show up near the surgery site, the LESS likely they are to be malignant.

When you are 6 plus years out, it becomes more likely they were not caused by the surgery but something else.

I am in a very different situation, I just had a biopsy for calcifications 7.5 years after lumpectomy for IDC.

I am new to this section of the board and I don't have a DCIS diagnosis yet, so forgive me if I don't have it all straight. My onc is concerned it's DCIS so it's a whole new world for me.

Good luck

After a lumpectomy, fat necrosis develops as a matter of course as surgery is trauma and trauma causes fat necrosis in the breast. It eventually calcifies and when it does the very early calcifications can be very worrisome. When we see it we go back to a pre-surgery set of images to see if they were there before and whether they are old and benign, or possibly DCIS that was not removed. If they are neither of these, and they are new and in the surgical bed, we suspect fat necrosis. On follow up imaging they eventually demonstrate the characteristic appearance of a fatty or low density center with eggshell calcifications. When you see that the calcs are actually curved around that focal low density you can make that diagnosis. New malignant calcifications from a local recurrence, in my experience, do not show up that fast after surgery. The arrow on the left points to fat necrosis. The arrow on the right points to arterial calcification in the breast.

Oh Emilie I'm so sorry! That is a bit confusing/shocking/frustrating that they didn't review and catch residual disease before they started your radiation. I'd be miffed. Honestly, that is why I started with lx and ended up with mx. Literally the DAY before I was supposed to go in for radiation mapping, I got back the 2nd opinion on my pathology which recommended an mri. At the time, it was a bit difficult for me as I was ready to move forward and get radiation started. But, in the end, they found 2 more areas of DCIS in a different quadrant and I ended up needing mx which meant NO radiation. What do you need from us? I am sending you healing light and big hugs! Please let us know how you're doing!

I had skips in my ducts too. A clear margin in my first LX was involved in the second LX.

I also had small oil cysts that looked suspicious in my MRI but were just like djmammo says, a natural side effect of any breast injury.

I think an MRI is a good idea, especially since its grade 3 which apparently shows up better. I had an MRI between LX 1 & 2, and it showed that the DCIS was much more widespread in my case. Since the surgeon can't see the DCIS, it makes sense to have a better idea of its extent before a second surgery.

Best wishes that this is quick and easy.

The "crawling" sensation worries me. It sounds similar to the "milk let-down" feeling one has when breast-feeding, and I was feeling this before diagnosis with DCIS. There's a thread here about other people who felt this before a DCIS diagnosis. Perhaps a biopsy?