Microcalcifications - Heterogeneous

Hi all, I’m just interested if many of your journeys started with microcalcifications? I’ve been having routine screening mammograms for the past 11 years due to family history. In Nov 2015 I was recalled for further investigations and told I had clusters of suspicious microcalcifications BIRADS 4 and a small lump BIRADS 3. I had a vacuum assisted biopsy for the microcalcifications and ultrasound guided core biopsy for the lump. Results were a fibroadenoma, adenosis and microcalcifications that needed reviewing in a year’s time.

So, I had a magnified mammogram last Wed and the results are that the microcalcifications have noticeably multiplied and are now heterogeneous. Intermediate to high chance of malignancy( same as last year) with more info needed. The radiologist who last year left a marker in in anticipation of another vacuum assisted biopsy is now recommending a surgical biopsy with wire localisation. I’m not sure as yet how long i’ll have to wait. Im not in uk and the process is dufferent here. Im telling myself all will be Ok but I am getting worried.

I find the waiting quite hard, and not knowing… . . .
Best Wishes all. Xx

Hi Poppyfields

I havent read anything about  what you have experienced Im afraid but just wanted you to know your post has been read . 

I had calcifications which turned out to be widespread low grade DCIS . There is a trial in the UK to  leave and monitor .  I wasnt brave enough to participate as there was other suspicious cells too , and I didnt want to sit and wait . 

I can understand your concern as there are now changes … perhaps knowing the changes have been detected and further tests are being carried out will give you an element of hope things can be sorted quickly if need be . Good luck … hope someone else on here can relate to your situation and speak to you . Big hugs xx

Hi Poppy fields and sorry to hear that you are going through a worrying time. I had microcalcifications and core biopsies. I waited 2xweeks to be told I had high grade DCIS. I have since had a WLE and a further cavity shave to remove almost 3cm of DCIS and get clear margins. I am now waiting to start 3 weeks of radiotherapy. All of this was a big shock, it has been upsetting and worrying and the worst part has been the waiting for results each time.the my care has been excellent though and the consultants, surgeons and my breast cancer nurse have been great at guiding and reassuring me through each step. I am not familiar with the terms BIRAD or heterogeneous but I am sure someone who does no them will come along and comment. Hope you get some reassurance soon xx

Hi. Thank you both for your comments.
Mine is now a 3cm area aswell and the fibroadenoma last year 11mm. I’m hoping to find out more info this week as to when the procedure will be done. It’s the waiting I find difficult!! Appointments, results… I waited a month over Xmas last year for the biopsy results from 4th Dec to 4th Jan!! So I’m hoping this year the results will be before Xmas.

My GP said they want to get alot more of it out this time rather than just smaller biopsy samples from the other methods. Not sure what type of anesthetic it will be… I would actually like them to remove the fibroadenoma aswell which would seem sensible…

BIRADS by the way is the world wide radiologist system used for assessing mammograms in terms of cancer risk. A score of 0 to 6 is assigned. They have another similar system for grading biopsy results. Ive heard in uk they tend not to tell patients what their birads was. Heterogeneous is the characteristic of the calcifications. My GP gave me a copy of the radiologist report, useful in some ways but not in others!!

As you say if it is Dcis its been caught early as the biopsy was OK last year.

Best wishes to you both in treatment and recovery. Xx

Hi. Thanks for you reply.
I’ve been told that most microcalcifications are clearly visible as benign and not suspicious on magnified mammogram and wouldn’t require a biopsy or further action except being kept an eye on but some are already or can become malignant. Depends on the structure, characteristics etc.
Mine were/are labelled "suspicious. "
My consultant told me last year that mine needed reviewing in a year as they can multiple and change into cancer and very commonly dcis.

Can I ask you if you don’t mind… The 2nd mammogram 3 years later when they found microcalcifications again… was it already Dcis or overtime did they develop into Dcis and the tumours? I mean, did you go back again a few months later for example??

I think you are right, it’s best that they remove all the microcalcifications… With margins??? and fibroadenoma. Better out than in by the sounds of it.

I’m moving back to UK next year so either way I can follow it up once I’ve registered with a gp and got back into the system.

I’m going to go to the hospital tmw and try and get a date and more info on the type of surgery that’s being planned.

Are you still having treatment, if you are I hope it’s going OK.

Thanks so much for your support all of you.
Best wishes.
Xx

Hi. I’ve received an appointment with the consultant for next week. If there is anything you think I should be asking, please let me know.

Xx

Hi, thanks for the info but I haven’t had my appointment yet!! I think you may have read Julie’s update this afternoon on the “waiting buddy” post??? She had good biopsy results today.

I’ll just recap…

My biopsies were benign December last year, but was told that the type of microcalcifications I have can multiply and change characteristics, hence the yearly mammogram follow up which I had on 16th Nov. My GP gave me the results last Monday, they have multiplied and changed characteristics and are labeled “suspicious” (again) with moderate to high risk of malignancy and surgical biopsy needed.
So, appointment with breast consultant is on Wed am this week.

I’m glad you responded actually cos I came across you earlier on a post and saw that you were put back into the 3 year screening programme and I was abit alarmed!! I’m returning to UK next year and started wondering if things are benign again this year that I may not get a year’s follow up like I would here, however Julie has been given a year’s followup which is abit encouraging!!

How are you? Are you still having treatment? You must have been really annoyed and felt it could have been caught sooner? I’ve been told and read on the uk cancer charity sites that DCIS in some cases (but not all) can become Invasive and that’s why dcis is treated with surgery because of the unknown risk of it spreading… how long etc… They have just finished the Dcis “watch and wait” study in uk. I think I read it on the cancer research UK website. Interesting stuff. Also that rarely microcalcifications can be cancerous or change overtime. But most are benign and don’t even need biopsy. But as you say, it’s very confusing receiving conflicting info from doctors!!

I’m wondering what they are going to say on Wed, will they take the whole lot out or just some of it. It’s not clear on the radiologist report he just says vacuum assisted biopsy is insufficient this time and I need a surgical biopsy with wire localisation.

The more I’ve read and think about it, I feel I just want the whole lot out and the fibroadenoma as well. The largest cluster of microcalcifications is 3cm and the fibroadenoma last year was 11mm but I don’t know if that’s grown or not… I just think if they only take a large sample of the microcalcifications and its benign that whilst that’s good news it will mean that in a years time I will be back here waiting to see if they have "multiplied/ changed characteristics… " again… ?

I hope your cold gets better quickly.
Thanks for taking the time to write. I appreciate it. Any further thoughts please let me know!!!
Xx

Hi. That’s OK! No problem! Thanks for the info. I’ll see what they say tmw. I’m assuming the current options are they either :

  1. take a larger sample for biopsy than they got last year with the vacuum assisted or

  2. they take the whole lot out now. Would that be a WLE???

I would prefer option 2 cos then they can biopsy the whole lot. I just think that if they only take a sample and it’s benign then this time next year I could be back in the same position cos they have multiplied etc… And having more mammograms, biopsies, more waiting etc!!!

Anyway just one more sleep and I should know.

I’m glad you are a Neddie!!!

Thanks and best wishes
X

Thanks. I’ll report back. X

It went OK this morning.

They want to do surgery under general anesthetic with wire localisation to remove the whole area of concern for biopsy. I’ve agreed to this. Had blood tests and an ECG after seeing the consultant and they decided I didn’t need the chest xray as I’m a non smoker. Next stage is pre op with the anesthetist which will be a week before surgery. They don’t know if it will happen before or after Xmas… They will phone me… So, back waiting…!!!

Anyway, progress I guess… But I’m a bit unsure about the general anesthetic bit… but maybe in the long run better as they maybe able to spend longer making sure they have it all… (I’m guessing.)???

Xx

Thanks Steph and Rubycat. I’ve thought about the general anesthetic and I’m happy to go with it.
I’ll keep in touch.

I’m pleased to hear your news. That must be a relief for you.
Thanks for your support
Best wishes.
Xx

Hi Poppy fields. I had a WLE op and then a 2nd op to achieve clear margins. I had never had a general anaesthetic before and to say I was scared and nervous is an understatement. They were brilliant both times. One minute they were talking to me the next I woke up in recovery with a lovely nurse beside me. Different nurses each time but all lovely. I know this can’t take your anxiety away but please try not to worry. Hope you don’t have to wait too long xx

Thanks Ali49.

Got family coming for Xmas in a couple of weeks time so that will keep my mind occupied.
Will just have to deal with it if the surgery ends up being at the same time!! I think it’s more likely it will be after Xmas tho…

Are you having any further treatment?

Best wishes
Xx

Hi Poppy fields
I am starting 15 sessions of radiotherapy on Wednesday 7th and finishing on Fri 30th dec. A bit of a break over Christmas but all done for new year hopefully. Not having to take any horm9ne tablets but will have yearly mammograms for the next 5 years. Good that you have family support over Christmas b

But don’t forget to take it easy. Let them spoil you x

I hope your radiotherapy goes OK.
Family members coming don’t know yet what’s going on, not really sure what if anything to say unless the surgery is scheduled whilst they are here…

Xx

Hi ladies, just wondering how you are doing?

I’ve got my pre op with the anaesthetist next Wed, so I expect surgery will be in January.

Any questions I should be asking?

Xx

Hi Poppy fields, good to hear from you
I have had 7 of 15 radiotherapy sessions and so far so good!
My pre op was with my BCN and I think that was when everything began to feel real! I asked all the things that were milling around in my head so write everything down that you are wondering about or any questions you have and take it with you. If you can take someone with you too as they will hear things that you might not and might also think of other questions too. My pre op did help to reassure me and allay some fears I had (although I was still scared!) I hope it goes smoothly and you don’t have to wait too long for op. How are you feeling?

Hi Ali49.
I’m glad your radiotherapy is going OK although I can’t imagine it’s easy but you sound in good spirits.

I’ve been writing down questions as I think of them relevant to the anaesthetist, radiologist (when I see him for the wire localisation ,) surgeon and the breast consultant (results day. )

It’s all abit different here than uk (no breast clinic, just different hospital departments to deal with) and I will only get to speak to I guess what would be the equivalent of the BCN when she phones me with the surgery date, certainly up until maybe a positive diagnosis it isn’t a support role. I hope not to find out if there is an equivalent BCN role after diagnosis!!!

I think here the key person for me so far is the radiologist who is a fabulous man, a real gem. I think I’ll get most of my questions answered by him.

I am apprehensive about the surgery/general anesthetic I think more than the possibility of having cancer right now and would have preferred to get this stage out of the way before Xmas despite family coming. But then ofcourse you just end up waiting for results. So I am OK (ish) thanks.
I think I’m just breaking it down into chunks in order to deal with it in conjunction with other pressures in my life currently.

Thanks for listening and hope you have a good Xmas, and your treatment continues ok. Xx

You too Poppy fields. Try to stay in the day and not think ahead. I just say to myself that ‘Today I am ok’! Xxx