Microcalcifications and mastectomy

KATZ56 · February 2010

Hi Everyone,

I'm looking for some advice. When I was 39 yrs old (14 yrs ago) my baseline mammogram showed microcalcifications in my left breast. They were removed via a surgical biopsy (lumpectomy) and found to be DCIS. Since they were all removed no further treatment was needed.

My oncologist told me at the time that odds were 50-50 they'd return and he would then recommend a bilateral mastectomy. My mammograms have been all clear since then until 6 mths ago. There were findings in my left breast & a follow-up mammogram was recommended in 6 mths.

I just received the results of the latest mammogram (by certified letter from the hospital--how warm & fuzzy!) and it's reporting "abnormal" & recommending a biopsy. I don't know the specifics yet. I have an appt. with my oncologist Thurs. but I'm pretty sure he'll recommend a mastectomy.

Everything I've read about microcalcifications support the mastectomy as the best treatment. Obviously I'm assuming that the microcalcifications have returned. If it's a lump or mass that's a totally different ballgame.

Can anyone offer advice on this topic?

Thanks so much for your help.

mariam_11_09 · February 2010

I don't know a whole lot but

I don't know a whole lot but I had a lump AND calcifications those biopsed turned out to be DCIS. However since the calcifications were spread out over 50% of my breast they (the breast surgeons and oncologists) recommended a mastectomy and it seemed like the best thing for me to do even though I would have preferred breast preservation.

I would have the biopsy just to make sure then also ask just how much calcification there is or how much has spread in your breast. If it is a small area perhaps ask if ther eis a chance you can get away with breast preservation if that is what you want. Also if you need a mastectomy the resonstructive surgery options, which can happen at the same time, are great, some require more recovery time. I know this might not be what you want, it wasn't what I wanted but I am pretty amazed at the results and they are not finished reconstructing yet.

I wish you well.

susie09 · February 2010

mariam_11_09 said:
I don't know a whole lot but

I don't know a whole lot but I had a lump AND calcifications those biopsed turned out to be DCIS. However since the calcifications were spread out over 50% of my breast they (the breast surgeons and oncologists) recommended a mastectomy and it seemed like the best thing for me to do even though I would have preferred breast preservation.

I would have the biopsy just to make sure then also ask just how much calcification there is or how much has spread in your breast. If it is a small area perhaps ask if ther eis a chance you can get away with breast preservation if that is what you want. Also if you need a mastectomy the resonstructive surgery options, which can happen at the same time, are great, some require more recovery time. I know this might not be what you want, it wasn't what I wanted but I am pretty amazed at the results and they are not finished reconstructing yet.

I wish you well.

My original mammo showed
My original mammo showed microcalcifications and the recommended treatment for me was a lumpectomy followed by rads and then tamoxifen. I had the lumpectomy and rads, but, still have not taken tamoxifen. I am not for sure why your chances were 50/50. My oncologist said that with my lumpectomy and rads, my chance of a recurrence or life span was the same as if I had a mastectomy. Good luck to you.

♠♣ Susie ♠♣

Skeezie · February 2010

susie09 said:
My original mammo showed
My original mammo showed microcalcifications and the recommended treatment for me was a lumpectomy followed by rads and then tamoxifen. I had the lumpectomy and rads, but, still have not taken tamoxifen. I am not for sure why your chances were 50/50. My oncologist said that with my lumpectomy and rads, my chance of a recurrence or life span was the same as if I had a mastectomy. Good luck to you.

♠♣ Susie ♠♣

I've had microcalcifications in both breasts
five years apart. Neither were malignant. I will probably have them again sometime in my remaining breast and I am hoping they are still benign. If it were me, I would have the lumpectomy to be sure of the dx of these microcalcifications, if that's what it is. I would not just automatically go for a mastectomy. My bc was from something else entirely.

Good luck with your dx and keep us posted.

Hugs, Judy :-)

Different Ballgame · February 2010

Calcification Then 2 Surgical Biopsies With Margins Not Clear
Started with calcification detected by mammogram. Calcification and 2 tiny, tiny, tiny discrepancies yield one of them was cancer. (I was upset because no could ever tell what size I had.) Two weeks later surgical biopsy performed which yield Margins Not Clear. Again, two weeks later another surgical biopsy performed and yet Margins Still Not Clear. Exactly what Margins Not Clear means is that microscopic cancer (which can only be seen under a microscope) is at the edge of the biopsied section.

So it was then suggested that I have a mastectomy. Now the cancer is microscopic (never had a tumor). Opinion of general surgeon was to have a mastectomy. I went to another hospital, met with an oncology surgeon, for second opinion. Everything reviewed by his team confirmed the findings by the first hospital.

Now, it was my decision as to what I wanted to do. Many factors came into play. I researched for 2-1/2 months. (Four days after second surgical biopsy, an infection developed and I had to heal from the inside -- out. That took 2-1/2 months to heal.) I ended up deciding on a mastectomy for both breasts - a good one and a cancerous one. I also had decided on breast reconstruction.

Bottom line...it is a crap shoot. How lucky do you feel? After 14 years from your first microcalcification, more microcalcifications have developed. The first thing you need to do is to have it biopsied. Don't assume anything. Next, if you don't like what your present oncologist is suggesting, then definitely seek a second and if necessary, a third opinion. Always seek second opinions from doctors at another hospital. Gather all your facts and ask for copies of all tests so you can review them at your leisure and review them more than once.

Also, buy Dr. Susan Love's Breast Book, 4th Edition. This book is vital. It truly is a bible for breast cancer. It will educate you to the medical terminology, what test results mean, various types of treatment, breast reconstruction, etc. etc. You can get this book via Amazon or check your local bookstore.

When you say oncologist - what kind of oncologist are you referring to? Is it a surgeon oncologist or is it a medical (Hemotology) oncologist that you are seeing? From my experience, each one has a different view point for treatment. In the beginning of my cancer I thought that there was 1 kind of oncologist. I did not know that there many different oncologists - again...surgeon, medical, radiation. Each one is independent of the other. I just learned that a few months ago. Up to a few months ago, my only oncologist was a surgeon oncologist.

Lots of Hugs and Lots of Love,
Janelle

Christine Louise · February 2010

Bi-lateral mastectomy a month ago
I have a similar situation. Mammogram showed extensive changes in microcalcifications in right breast, then biopsy confirmed DCIS, LCIS, and Invasive Lobular. Surgeon recommended bi-lateral mastectomy since LCIS so often indicates that cancr is likely to occur later in the other breast. I didn't want to "wait for the other shoe to drop," so I went with the bi-lateral for peace of mind.

Aha! Tests on the removed tissue showed the left breast had "worse" cancer than the right. And to think that I easily could have opted to not remove the supposedly non-cancerous left breast.

I'm not saying that bi-lateral mastectomy and the immediate reconstruction I'm currently undergoing are a walk in the park, but I feel I made the right decisions. I also appreciate that my reconstructions will be very symmetrical and will remain so through any later changes in my weight.

As breast cancer goes, microcalcifications and DCIS are early-stage, which is good. Best of luck to you!

sunny_girl · February 2010

MRI
Clusters of microcalcifications are often caused by cancer cells that are growing very rapidly and die, leaving behind the tell-tale microcalcification. In and of themselves, they are harmless. It is the DCIS/cancer around them, forming them, that is the problem. Cancer is cancer with or without a palpable lump. Treatments have changed over the past 14 years, and you may want a second opinion if you are diagnosed with anything serious.

I'd hope your surgeon would recommend a breast MRI -- as a diagnostic tool, and to see the extent of cancer before considering any surgery, and to see if there are any problems with the other breast.

A single cluster of microcalcifications is easy enough to remove, and a single non-palpable cancer is also easy to remove with lumpectomy (at a facility with the proper equipment to place wires in it before surgery). Survival rates are the same with lumpectomy/radiation or mastectomy. Mastectomy is a tough surgery, and doesn't completely eliminate the risk of breast cancer because it leaves behind enough tissue that breast cancer can still return.

For now, I'll keep my fingers crossed this is simply one of those many false positives, with an unnecessary biopsy, and proves to be nothing

Kylez · February 2010

sunny_girl said:
MRI
Clusters of microcalcifications are often caused by cancer cells that are growing very rapidly and die, leaving behind the tell-tale microcalcification. In and of themselves, they are harmless. It is the DCIS/cancer around them, forming them, that is the problem. Cancer is cancer with or without a palpable lump. Treatments have changed over the past 14 years, and you may want a second opinion if you are diagnosed with anything serious.

I'd hope your surgeon would recommend a breast MRI -- as a diagnostic tool, and to see the extent of cancer before considering any surgery, and to see if there are any problems with the other breast.

A single cluster of microcalcifications is easy enough to remove, and a single non-palpable cancer is also easy to remove with lumpectomy (at a facility with the proper equipment to place wires in it before surgery). Survival rates are the same with lumpectomy/radiation or mastectomy. Mastectomy is a tough surgery, and doesn't completely eliminate the risk of breast cancer because it leaves behind enough tissue that breast cancer can still return.

For now, I'll keep my fingers crossed this is simply one of those many false positives, with an unnecessary biopsy, and proves to be nothing

I wouldn't think that a
I wouldn't think that a mastectomy would be recommended unless the microcalcifications are all over your breast. Usually they are in a cluster and can be removed with a lumpectomy, as mine were. I also got a MRI before my lumpectomy to verify the cancer in my breast and to verify that there was none in my other one. You should ask for a MRI. Good luck.

KYLEZ ♥

cathyp · February 2010

Kylez said:
I wouldn't think that a
I wouldn't think that a mastectomy would be recommended unless the microcalcifications are all over your breast. Usually they are in a cluster and can be removed with a lumpectomy, as mine were. I also got a MRI before my lumpectomy to verify the cancer in my breast and to verify that there was none in my other one. You should ask for a MRI. Good luck.

KYLEZ ♥

MRI's for microcalcifications
it should be noted that Breast MRI's and Ultrasounds can not detect microcalcifications. Also, as a diagnostic tool alone, there can be many false positives.

Megan M · February 2010

Christine Louise said:
Bi-lateral mastectomy a month ago
I have a similar situation. Mammogram showed extensive changes in microcalcifications in right breast, then biopsy confirmed DCIS, LCIS, and Invasive Lobular. Surgeon recommended bi-lateral mastectomy since LCIS so often indicates that cancr is likely to occur later in the other breast. I didn't want to "wait for the other shoe to drop," so I went with the bi-lateral for peace of mind.

Aha! Tests on the removed tissue showed the left breast had "worse" cancer than the right. And to think that I easily could have opted to not remove the supposedly non-cancerous left breast.

I'm not saying that bi-lateral mastectomy and the immediate reconstruction I'm currently undergoing are a walk in the park, but I feel I made the right decisions. I also appreciate that my reconstructions will be very symmetrical and will remain so through any later changes in my weight.

As breast cancer goes, microcalcifications and DCIS are early-stage, which is good. Best of luck to you!

My mammogram showed the
My mammogram showed the microcalcifications and I had the core needle biopsy then that showed I had breast cancer. My treatment was a lumpectomy and then rads. I felt very lucky that I could keep my breast as I don't think I could face having a mastectomy. The survival rate, as someone posted, is the same as they can never get all of the breast tissue with a mastectomy. Just do what is right for you. Let us know what you decide or what your oncologist and plastic surgeon recommends. Sometimes you have choices and sometimes you don't. Best of luck!

Megan

Eil4186 · March 2010

I am sorry that this
I am sorry that this stressful thing is happening to you. I would have the biopsy first deciding on a mastectomy. There could be a chance that it is fibrocystic rather than cancerous. I had "very suspicious" calcium show up on my last mammogram. The doc was so concerned that she did a biopsy the same day and it ultimately turned out to be fibrocystic.
It's worth a try.

Microcalcifications and mastectomy

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