Calcifications and biopsy

It depends upon how anxious this is making you, although 2 months is an awfully long time to wait if it was assumed that you had a possible malignancy. Since there's no way of knowing if the cyst is just a benign cyst or what is in the actual tissue, a biopsy, as you obviously know, is the only answer. So it's really a tough call....if there is some cancer, 2 months would be too long in my book, but if not, it's of course, better to have your insurance pay for the procedure and to know right away. Also,cancer usually takes a number of years to grow, so if you had a malignancy, probably waiting a bit won't make a big difference, unless it were a particularly aggressive tumor but, unfortunately, that caan only be determined by pathological analysis. So I guess that, if I were you, I'd try to locate another specialist and maybe see if they can at least do a needle aspiration of the cyst if not a core biopsy of the tissue. The bottom line is....what do YOU want to do and how uncomfortable will you be waiting 2 months for a definitive answer?

~Marin

Almost all cysts are benign, although I don't know about complex cysts.



Some breast lesions can show up in one imaging system and not others. They could be related. When I had calcifications biopsied, there was more than one patch of them, and they biopsied each.



Biopsy is the 'gold standard' way of knowing what is going on. If they are recommending biopsy, then I'd go ahead with that - is the biopsy covered? In the unlikely event that it was cancer, then that information would probably put you on a faster track with the surgeon who is covered by your insurance.



If they are near each other and show up on mammo together, they may be able to biopsy both at the same time. (Often calcifications show up on mammos and not on ultrasounds, and often cysts show up on ultrasounds and not mammos. This is by no means an absolute rule.)

The cyst and the calcifications are probably unrelated.  I've had cysts all over both my breasts and I've also had calcifications.  From my understanding, there is no relationship between the two.

To be defined as a "simple" cyst, a cyst has to meet some very stringent criteria.  Simple cysts are almost always benign.  They have a single compartment of fluid, well defined walls..... Anything else is called a "complex" cyst.  Complex cysts can be cancerous, although one report I read indicated that less than 0.5% of complex cysts are cancer. Still, if you have a complex cyst, it should be aspirated.  I've had lots of aspirations.  It's a 2 minute, painless in-office procedure in which the doctor inserts a needle & syringe into the area of the cyst, and retrieves all the fluid.  Just like that, the cyst is gone.  If the fluid is clear or cloudy, whitish, yellowish or greenish, it's fine.  If the fluid includes blood, then the sample should be sent to the lab to be checked.  Some people may consider an aspiration to be a biopsy, but really it's not.  That might be why it's been suggested that you only have a biopsy on the calcifications.  The calcifications require a stereotactic biopsy.  This is a type of biopsy done using a core needle (a holllow needle), with the technican guided on the needle placement by a mammogram machine.  The cyst doesn't need to be biopsied - it can simply be aspirated on the spot by the surgeon.  If the surgeon doesn't offer to aspirate the cyst, you should definitely insist on it.

As for waiting 2 months for the appointment, medically that's probably not a problem. Most breast cancers have been in the breast for 8 - 10 years before they are discovered.  And chances are that your calcifications are run-of-the-mill, benign calcifications.  But if they're not, they may be a sign of ADH (a pre-cancer), DCIS (stage 0 breast cancer) or possibly earlystage IDC (stage 1 breast cancer).  These conditions are usually considered to be slow-growing.  So it's unlikely that 2 months would cause a problem medically.  The question is whether you could get through 2 months without worrying too much and stressing yourself out.  I think the suggestion of having your doctor call the surgeon's office to try to get you an earlier appointment is a good idea.

Lump which I discovered a couple of weeks ago, I felt, husband felt, dr felt; did not show up on mammogram in March; did not show up on sonogram a couple of weeks ago; but dense breast (implants), sister w/breast cancer at 39 - take no chances.  B9.  May have to get lumps removed (through surgical means) everytime because of implants...dr (GYN) won't stick a needle in a cyst, even to try to draw out the fluid in it for biopsy, so just go in, go to sleep, wake up w/results.  This is my 3d B9 tumor.  Fatty lumps - no reason, just there (but I did breast feed 2 children).  The last 2 lumps have been right below the nipple area.  One scar very visible; other 2 right around nipple area...don't show.  But boy was this last one sore...and very bruised.