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Thursday, August 21, 2014
Breast cancer biopsy question
I am a 56 year old female who just had a mammotone biopsy for a very small cluster of microcalcifications in the upper left quadrant of my left breast. The surgeon rated them as BIRAD 4. I did not have these on my mammogram last year, so they are new. I asked the surgeon if this is cancer, did we catch it early, and was its small size a good sign. He said he couldn`t say until he sees the biopsy results. The assistant said that all the calcifications were captured in the biopsy and that was good, but I didn`t ask why that was good. Can you tell me why the doctor couldn`t say that if this is cancer we caught it early? Why is getting them all in the biopsy a good thing? The doctor took 5 tissue strands of what looked like 4 linked sausages each. The microcalcifications were in one of the links. Why did he need to take so many samples? Do untreated cancerous microcalcifications eventually become lumps that can be felt? I can`t find information about that anywhere on the web, so I don`t have a clear picture of what kind of a breast cancer that can`t be felt is. I couldn`t think to ask all this during the procedure. No one on either side of my family has had any kind of cancer.
First, remember that you should have more answers in just a few days when the biopsy results are available.
The surgeon cannot tell if the calcifications represent cancer—the biopsy is necessary to tell this. Calcifications sometimes indicate cancer. If the tissue removed is cancerous, then the small size and newness of the finding is a hint that the process was caught early and the cancer would have a good prognosis. But since sometimes a more extensive cancer could be found, your doctor is being cautious to ask you to wait until there is more information. Several samples are taken to be sure the whole area (or as much as possible) that contains the calcifications has been removed. If microcalcifications represent cancer, and are not removed, they can become a lump that can be felt. All cancers initially start as a tumor too small to be felt. The goal of mammograms is to find cancers at this point, before they become larger tumors. Whether your microcalcifications are found to be cancerous or not, you should be very glad that you had a mammogram, that the abnormality was noticed, and that you had your mammotome biopsy.
Paula Silverman, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University