Microcalcifications and Stereotactic Biopsy - Do What You Gotta Do
Your Mammogram Was Abnormal....
"Sometimes, wounds are sources of growth."
– Rachel Naomi Remen
So, You Have Microcalcifications of the Breast
If you are reading this article, it is most likely either because you have had a recent mammogram showing microcalcifications of the breast, or because someone you know or love has. Well, the initial step is over. Congratulations for having done the right thing and having gotten a mammogram. It is not fun, but it is something we women must be accountable for in the interest of protecting our health.
Unfortunately, some mammograms will require further investigation, and for those who have microcalcifications, your diagnostic journey may just be beginning. Harrowing and unnerving, yes, but keep in mind, these interventions are all in the name of keeping you healthy and kicking for years to come! Try to look at this journey in a positive light.
What Are Microcalcifications Exactly?
According the Mayo Clinic, calcifications as related to mammography are calcium deposits that form in the breast tissue. They typically do not suggest the presence of cancer, however, there are some instances where they might.
There are two basic types, macro and micro. Macrocalcifications show up on mammograms as larger white spots, and they almost never require further evaluation. Microcalcifications, however, show up as very small bright pinpoints. If they are clustered together or they appear with certain characteristics, they need to be further investigated with either more imaging or a biopsy, as they can suggest the beginnings of cancer.
Microcalcifications: What They Look Like
Ductal Carcinoma In Situ (DCIS)
Ductal Carcinoma In Situ (DCIS) is a 0-stage cancer. It is the very earliest type of cancer.
Why Might Microcalcifications Be Dangerous?
Microcalcifications sometimes appear in a way that might suggest they are forming within ducts. If many are forming in a tight cluster, for example, this can indicate the early stages of ductal carcinoma in situ (DCIS). As outlined in the article Microcalcifications Found In Mammogram Can Lead to Diagnosis of DCIS, Early Breast Cancer, DCIS is a 0-stage cancer. It is absolutely the earliest stage of cancer and is contained in the milk ducts (thus the term in situ). That means it has not spread yet—and early diagnosis can be life-saving because it can potentially prevent a woman from developing more serious forms of breast cancer later. This is exactly why women have mammograms starting at age 40, especially if they are high-risk candidates for breast cancer. Regular mammograms will hopefully catch disease at its earliest point.
The Importance of Yearly Mammograms Starting at 40
About Potential Ductal Carcinoma In Situ (DCIS)
The American Cancer Society estimates that 60,000 U.S. cases of DCIS are diagnosed yearly because of screening and early-prevention interventions. They are most often identified by the appearance of suspicious areas on mammograms, including the presence of some microcalcifications. Microcalcifications are common findings, and only a small percentage of these are ever actually associated with cancer. However, doctors tend to be very careful about screening for DCIS once a warning sign appears. One very common approach following the recognition of the presence of microcalcifications within the breast is stereotactic biopsy.
Why A Biopsy May Be Appropriate - Microcalcifications and Breast Cancer
Stereotactic Biopsy: What Scared Me Most
When my mammogram came back with the appearance of abnormal microcalcifications, my doctor told me I needed a stereotactic biopsy. The worst part for me was the way that the staff where I had my mammogram reacted. They acted like I had cancer—and it was shocking to me as I had expected to just pop in and out of there, incident free. I thought of my children growing up without a mother, and this terrified me to the core.
The Stats Are On Your Side When It Comes To Microcalcifications
However, in the case of microcalcifications, I soon realized and reassured myself, that the type of cancer microcalcifications suggest, is really not the worst type of cancer to be diagnosed with. It is preliminary and mostly, a prevention for further difficulties. If you are having this problem, I urge you as someone that is in the boat with you, to remain calm. Most findings turn out “ok.” As a matter of fact, upwards of 80% of microcalcifications turn out to be benign - with only 10-20% of those that are biopsied being positive for cancer, as suggested in the video above on the relationship between microcalcifications and cancer.
Armed with this knowledge, what I found mentally difficult to face, was the unknown of where I was going to go to have the biopsy done, who my “breast surgeon” would be. The planning for it was very difficult, especially while daily life ticked on at its usual furious pace, nothing stopping and no one giving me a pass to crumble a bit.
My results turned out to be benign, but now I am six months later and after having a follow-up visit, I need another biopsy . I am back at square one, trying to take my own advice. A new cluster has sprung up. I relate this only to evidence that I, in writing this to women out there that are scared, am again, in the boat with you. But, we can do this! It’s a good thing. It’s prevention.
What Is A Stereotactic Breast Biopsy?
Scheduling A Stereotactic Biopsy - Things To Consider
Ok. On to the actual biopsy. The most common type of biopsy that is recommended for this type of problem is a stereotactic biopsy, as described very well in the video to the right. I went through this. Here’s the deal. It’s going to be quite a surreal experience, but you are going to be just fine! If you do not go to a mammography center that has the ability to biopsy there, or if you don’t have a long-time doctor who has these in-office capabilities, I recommend finding a place that also has surgeons and cancer specialists on staff, like a well reputationed hospital with state-of-the-art equipment and top doctors. You want to choose a good facility in case you need further follow-ups or treatments and you always, always want to choose facilities with experienced and highly recommended radiologists to read your reports. The better, the better in cases like these. (Call your insurance and choose a good facility that is in-network if you can. You don’t want to be hit with the stress of paying for more than you need to – especially if down the line, you will need a repeat like me.) I think the unknowns and who’s and what’s are hard enough, so if your facility is comprehensive it can make the future easier, should you need more help with this issue.
Getting A Stereotactic Biopsy
"Courage doesn’t always roar. Sometimes courage is that little voice at the end of the day….."
- Mary Anne Radmacher
Tips for Preparation for Stereotactic Biopsy:
Your doctor will most likely recommend that you stop taking the following 5 days before your biopsy:
- Aspirin-associated products like Motrin, Advil, Aleve, Excedrin
- Fish oil supplements
- Vitamin E
… and don’t forget your prescription from your referring doctor for the biopsy!
What to Expect During Stereotactic Biopsy
In a stereotactic biopsy, as more objectively detailed in the Medline Plus’s article Breast Biopsy, they use mammography to pinpoint the exact place in the breast that will need to be removed. They may use either a needle, core needle (hollow), vacuum device, or both to remove a bit of tissue surrounding the areas of where the calcifications are through a small incision, so they may test it for abnormal cell activity. Something is making those calcifications and they want to find out if it is abnormal or precancerous tissue. Anyway, I experienced the use of a vacuum device. I was laid face down on a table with a hole in it and the medical personnel went under the table to access the area. Some people have it done sitting up.
The nurses were so nice and comforting. The procedure itself was interesting and truly, it did not hurt. It only lasted about an hour. It wasn’t that bad. However, I recommend that you do have someone take you. Do not go alone. They told me I would be able to drive myself home, but this was just not true at all. I was exhausted after the procedure.
After the procedure, you can expect to bleed and be quite sore and bruised (this is why they recommend that you do not take any blood thinning agents such as aspirin for 5 days prior to your procedure). You will feel a bit compromised for at least a week, while you await your results call.
Know, a band of women are behind you, my reader. We are collectively all rooting for your off-the-hook news. But should you need follow-up, you are still going to be ok! Again, detection of an abnormality is a good thing. Early detection, which this type of searching for answers is a part of, is good.
Waiting For Results of Your Stereotactic Biopsy
Most likely, your results will take 3-5 business days to complete and a copy will be sent to your referring physician. It really is difficult waiting for your results, but with your support system around you, which you should both cultivate and take full advantage of, you will make it through. Keep busy!
Common Treatment Options for DCIS
- Lumpectomy with radiation
- Simple mastectomy
Further Treatments for Ductal Carcinoma In Situ - Should You Need It
You can further research what treatment options will be made available to you in case you are diagnosed with DCIS following your biopsy at sites like The National Cancer Institute's webpage for DCIS Treatment Options . Remember, that this only happens in less than 20% of cases that are recommended for biopsy. However, if you are diagnosed with this early stage of cancer, treatment options for most people include the following choices.
The first most radical approach is simple mastectomy. You can decide to go big and eliminate the problem for the future. A second option would be lumpectomy most likely with radiation therapy. I recommend the consideration of options be tabled until you are armed with the facts of your particular case. Taking one step at a time has its merits. However, if information is power for you, considering what choices you might opt for in such a case may help you to prepare in case you need to revisit these options later.
I know. For such a “benign” type of cancer (pun intended), these are pretty harsh treatment options. Take a breath. You are not there yet and may not ever need to be. The important thing is, it is a highly curable thing. In fact, sites like The Harvard Medical School Family Health Guide support the fact that if treated appropriately, there is close to a 99% cure rate for early DCIS.
The Good News:
Only 10-20% of women biopsied for microcalcifications go on to be diagnosed with ductal carcinoma in situ…. and the cure rates following appropriate treatment of this disease near 100%!
Good Luck and Be Brave!
Rest assured, friends getting this biopsy for microcalcifications: There is very little chance you will from this one! So, chin up. Everything is going to be ok. And believe it or not, I can say that, in this case. Now have a little cry if you need to, put on your big girl pants, and go get your biopsy, and then eat some chocolate-chunk ice cream for a job well done! I’m with you in heart!
Do What You Gotta Do
One Last Word About Breast Cancer
As I waited for my six-month follow-up mammogram (to my original biopsy) the other day, I smiled at the woman across from me. She said, “No one wants to be here; but we do what we gotta do.” I saw her again out of the corner of my eye as I was leaving the room, after I had been told I needed to get another biopsy. I averted my eyes as I knew she heard me trying to convince the nurse that I probably didn’t really need one, right? Anyway, I didn’t want to meet her gaze as I didn’t want her pity, so I walked by quickly to my dressing room with my chin up.
We are all statistics for each other. My friend Kim, in college, was one of our 8 close girlfriends. One in 8 women suffer from invasive breast cancer in their lifetime, according to cancer.org. Kim was our 1 for that group of young, invincible women, and she died last year. I am grateful for her for taking our stat on. I am sorry she was the one, as I know she had many a sad and suffering day.
Now, we are all part of new groups of women, and at times, we might have to take the stat (in this case, it’s not so bad and the cancer is non-invasive!). But together—together—we are the collective of women, and I am grateful for the beautiful company.
To my dear friend, Kim Atwater. I miss you always, and hold you in my heart.
What Do You Think?
Have you ever encountered microcalcifications in your mammogram or someone's you love?
If yes, were the final results determined as:
- Handling Anxiety When You Need a Follow-up Mammogram
So you've be told you need additional testing after your mammogram. Handling the anxiety can be rough.
Share Your Experience
If you would like to share your experience about microcalcifications to help readers gain further insight into this topic, please feel free to add them to the comments section below. Thank you!