Linear Cluster and Punctate Calcifications shown on Mammogram

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Eng01
Eng01 Member Posts: 2
edited February 2020 in Not Diagnosed But Worried

Hi, Everyone!

I was hoping someone could give me some advice. I am 33 years old, no kids. No major health problems.

1st diagnostic mammogram: December 9, 2019:

Findings: The breast tissue is heterogeneously to extremely dense, which may obscure small masses and lowers the sensitivity of mammography. A band of glandular tissue is noted in the upper quadrant of the left breast. Ultrasound is suggested for further evaluation.

In addition, in the right breast retroareolar there is a linear cluster of microcalcifications for which magnification films are recommended.

BI-RADS 0: Incomplete screening mammogram. Recommend additional evaluation of both breast with additional mammography and ultrasound.

2nd Diagnostic Mammogram: Jan 22, 2020 (2 weeks after initial mammogram):

I had the follow-up mammogram (on the right breast where the microcalcifications were seen) and ultrasound (on the left breast where the glandular tissue was seen).

Mammogram Findings (on the right): The breast tissue is extremely dense, which lowers the sensitivity of mammography. There are a few groups of faintly visualized, punctate calcifications within the right breast. Right breast calcifications are probably benign.

BI-RADS: BI-RADS 3: Probably Benign

Ultrasound Findings (left): No abnormality identified.

The doctor explained that findings such as this are usually associated with early stage breast cancer (DCIS) and to come back in 6 months. I walked out of the doctor's office confused. I was like you just explained the possibility of it being cancer, but you want me to come back in 6 months? What?

I did some research afterwards and found that the shape and pattern of microcalcifations, linear clusters and puncate, is a cause for concern. Or is it really?

Isn't linear & punctate signs of DCIS?

Should I be worried? Should I get a second opinion? Or should I wait the recommended 6 months?


Has this happened to anyone? Did you wait for 6 months and later diagnosed with BC?

Any help/guidance is greatly appreciated.

FYI: All my care is at the Veterans Affairs (VA) Hospital and I was informed that they do not do breast MRIs (I don't know how true that is).

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  • djmammo
    djmammo Member Posts: 2,939
    edited February 2020

    Eng01

    "Isn't linear & punctate signs of DCIS?"

    Linear branching is a sign of DCIS. Punctate is usually associated with benign entities.

    The diagnostic study is a more detailed, tailored exam performed to better evaluate the specific findings on the screening exam. For this reason the conclusion of the diagnostic exam supersedes the impression of the screening exam.

    See this reference regarding breast calcifications.

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited February 2020

    Calcifications themselves are not the problem and do not "develop into" anything. Calcifications "can" indicate an underlying process, but calcifications are themselves inert. Most of us develop calcifications as we age. It is only when they form specific patterns seen on imaging that they MAY indicate something is going on.

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  • Khakitag
    Khakitag Member Posts: 46
    edited February 2020

    mine were linear and branching, birads 4C, diagnosed as ADH. I convinced myself it was nothing, but it was upgraded upon excisional biopsy to DCIS. Punctuate calcs were seen in the area during the surgery. If you’re confused or concerned, get a second opinion. I think drs are a little flippant about DCIS Dx because it isn’t life threatening, but the treatment for it can sure be life altering, and the fear that we live with wondering when or if it’ll come back is real.

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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2020

    Ndth86, while calcifications are more common in women over age 50, they certainly can develop in women who are younger.

    As for "from what I've read, these calcifications have a 50% of developing into something", this is absolutely incorrect. First, as MelissaDallas indicated, calcifications don't develop into anything. Second, also to her point, while calcs can be a sign of the presence of cancer cells, the vast majority of breast calcs - over 90% - do not represent cancer.

    You mention that your calcs are scattered. I looked back at your earlier posts to see if you had provided a more detailed description of your calcs. What I found is that your calcs were identified on a mammogram almost a year ago, and you've said that they are round and scattered. This description is suggestive of run-of-the-mill common harmless calcs.

    https://radiologyassistant.nl/breast/breast-calcifications-differential-diagnosis

    image

    image

    In looking at your previous posts, I see that since March of last year you have come here with a long list of different breast concerns. First was a lump, and you never reported back on the outcome of your diagnostic mammo and ultrasound. Then you posted about nipple discharge, then zapping pains, and finally a mass under your collarbone. Again you never reported back on the outcome of your imaging and doctor's appointments. I trust therefore that all your imaging has been negative and your doctors don't have any concerns?

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  • Beesie
    Beesie Member Posts: 12,240
    edited February 2020

    Ndth86, in this thread and in response to one of your earlier posts, I have spent a lot of time trying to provide helpful answers that are specific to your situation, as you have explained it. Many others have offered advice and suggestions and support as well. Every time you have said that you will let us know what happens with your imaging and appointments... and then you go dark and don't post again until you are here with another concern.

    I am very sorry that you have such a strong family history of breast cancer. With your mother's history, I completely understand your concerns. I would like to offer support and information (and I have been) but without knowing your whole history (family history and outcomes/follow-ups on previous concerns), anyone who responds to you may not be providing relevant information, which isn't helpful to you and might lead you down the wrong track, and is a waste of time for those responding.

    For those who have responded to you and offered advice and support, having the courtesy to let us know the result of your imaging and appointments, as you've said you would, would be nice. This is particularly true given that you have this strong family history and many breast issues, and therefore unfortunately will probably be back here in the future with more questions. Everyone here (myself included) wants to help, but it has to be a two-way street.

    As a suggestion, you might want to add a signature line to your profile, explaining your family history of breast cancer. That will help those who respond understand that your concerns may be different than the average 34 year old, and they can respond accordingly.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited February 2020

    I have to agree with Beesie. Many of us get very caught up with posts and when the poster never comes back to let us know the results are benign - or not - we feel we have misplaced our concern.

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  • TB90
    TB90 Member Posts: 992
    edited February 2020

    I have to say I somewhat disagree. Those of us who chose to remain here to help, do so for our own personal reasons. Thank goodness many chose to do so. But to expect appreciation or even decency from others is unfair. Everyone responds or not for their own reasons. It would be wonderful if we could be respected for what we do. Posters have many issues, fears and even phobias. Mental health issues including hypochondria and severe anxiety and depression. Many are disorganized and have learning challenges. But most are truly doing the best that they can do. To expect more is simply unfair and unrealistic. To assume they are ungrateful or disrespectful is to assume that they have the personal resources that you have. But I want to thank you for everything you contribute for us all. This is not a specific reference to the previous poster as I have no opinion as to why she does not respond. Hopefully she is now encouraged to do so recognizing how important this would be for you

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  • Eng01
    Eng01 Member Posts: 2
    edited February 2020

    Hi, all!

    Sorry for the late response. I was recently involved in an accident, I am okay but my week has been hectic. I did not realize how active my thread was til now. I will keep an eye out for now on.

    djmammo, I guess I was a bit confused about the mammogram terminology. Both mammograms I thought were diagnostic. I was having breast pain in the area the microcalcifications were found. I've read many articles about punctate calcifications and I have found that benign isn't always the case.

    Beesie, In your image above. It states that "Suspect DCIS when the calcifications are small, i.e. punctate, and show some heterogeneity especially when in cluster, linear or segmental distribution". This seems pretty alarming to me considering the fact that I have punctate and linear clustered microcalcifications. I am wondering if I should push for a second opinion.

    Khakitag, so punctate calcs could be concerning because if you had them and were later diagnosed with DCIS , then there is possibility my findings could be the same. .... I have been trying to sike my mind into thinking it's nothing, but that only works for a couple of days then it's back to wrecking my brain about this.

    FYI: The VA does not want to refer me to see a breast specialist. They feel the "active surveillance" route is the best method at this point. So, I will have to wait the recommended 6 months. I am still a bit concerned, but I have no choice. I have an adopted 1 year old son, so I want to make sure I am doing whatever it takes to be here for him.

    Thanks so much everyone for all your help! I really appreciate you all for taking the time out of your day.

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