Question about Pleomorphic MicroCalcifications

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momof5a
momof5a Member Posts: 5
edited October 2020 in Not Diagnosed But Worried

I just had a routine mammogram that turned into a diagnostic mammogram and ultrasound this past week. My mammogram report said the following:

Clustered, pleomorphic micro calcifications spanning 4.7 cm in the upper outer right breast, 8 cm from the nipple. Bi-rads 4: suspicious for malignancy.

I'm 42 years old and about 5 years ago had a intraductal papilloma removed in my left breast that came back with atypia (not even sure if this is relevant).

I have a stereotactic biopsy scheduled for this Tuesday. I realize I have to wait for biopsy results and we all know that the waiting stinks and I just want answers! Against all sane advice, I have turned to the internet searching for answers, a similar situation- anything really at all that will give me an idea of which way this will go. I'm not scared as I know even worst case scenario that I will be fine. I know the statistics are in my favor. I've driven myself bananas over the last few days and think I may have even earned myself a google medical degree-except in my google medical practice, I still have some questions that I can't seem to find the answers to. If you've gotten this far, thank you and these are my questions:

1. Are pleomorphic micro calcifications the same as fine pleomorphic calcifications?

2. Does the span of 4.7 cm mean anything? Is this considered a large area? (I have smallish breast)


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

    momof5a,

    Sorry that you've joined us here.

    I believe pleomorphic microcalcs are the same as fine pleomorphic calcs - the "micro" filling in for the word "fine". But even if they are different, both of these types of calcs are considered suspicious - either a BIRADs 4 or a BIRADs 5. In your case, because of the clustered formation, they have been designated BIRADs 4.

    An area of 4.7cm is large. But the calcs could be a mix of different conditions - this is actually very common. So if DCIS or invasive cancer is found, it could just be in one small area. I had 2 areas of microcalcs that were over 7cm in size, also in a small breast. As it turned out, almost all of it was DCIS, although I also had a tiny 1mm microinvasion of IDC, some ADH (atypical ductal hyperplasia) and pretty much every fibrocystic condition in the book. With that much DCIS, even though DCIS is non-invasive, my only surgical option was therefore a MX.

    The atypia might be relevant. Do you know specifically what type of atypia you had? ADH and ALH (atypical lobular hyperplasia) are high risk conditions. While most often atypical cells don't develop any further, they can continue to evolve to become DCIS, and DCIS can evolve to become invasive cancer. About 25% of women who have ADH or ALH do develop either DCIS or IDC. But another type of atypia (FEA, flat epithelial atypia) presents very low risk.

    On their information pages, Breastcancer.org have this image, which shows how cells can progress from ADH to become DCIS and subsequently, IDC. It doesn't always happen this way, and the progression can stop at any point, but this explains why the presence of atypia increases risk.

    image

    Good luck with the biopsy. Hopefully the results are benign! Let us know how it goes.


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  • Peacetoallcuzweneedit
    Peacetoallcuzweneedit Member Posts: 233
    edited October 2020

    When I was diagnosed in 2017 at 47yo - that was the description used on my mammogram of my left breast. ( I had different types of microcalcs in my right) I had 60mm+ in my left breast and when I challenged the size of what that meant, my nurse navigator pretty much brushed me off saying it didn't mean anything. However, I knew different. This type of microcalcs, as I'm sure your google medical degree has already explained, are exactly what your results stated --> highly suspicious. My radiologist who gave me my diagnosis stated I needed to get to my breast surgeon and get my questions answered about size at that point. My breast surgeon confirmed that yes - I had a little over 6cm of DCIS. So at this point what your mammogram shows is an area ~4.7cm. In the arena of breast cancer or breast conditions- that is a large/largish area. Your biopsy will absolutely tell you what it is at the point that is/will be removed. The waiting does suck....I'm sending you positivity.

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  • momof5a
    momof5a Member Posts: 5
    edited October 2020

    Thank you for taking the time to respond- I really appreciate it and will keep you all posted!

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  • momof5a
    momof5a Member Posts: 5
    edited October 2020

    Thank you for taking the time to respond in such detail. I really appreciate it and will keep everyone posted either way!

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  • momof5a
    momof5a Member Posts: 5
    edited October 2020

    thank you for taking the time to respond. My previous pathology report for the intraducal papilloma cited ADH- I was just told that I’d have preventative screenings every 6 months instead of 12. My last mammogram was March of 2020 and the calcifications are new. Also worth mentioning that I had papillary Thyroid cancer and had a total thyroidectomy 2 years ago and have been of thyroid replacement hormones since. Again, not sure if it’s relevant or not...

    Hopefully my breast surgeon will give me some indication based on what she sees when she does the biopsy. Thank you again!!

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