cluster calcifications and biopsies

[lesliebtq]

Hello, My name is Leslie, My last mammogram showed clacifications in my right breast, and newer calcifications in the left. I was told by the radiologist that I needed a needle biopsy of the right, and a surgical biopsy of the left. I made an appointment with a surgeon and scheduled for the surgical biopsy. I did get a recommendation from my primary doctor for a second opinion. The breast specialist surgeon recommended an MRI.
FINDINGS: Right Breast: Dense parenchymal pattern. Architectural distortion posterior central probably post-biopsy scar. Patient has history of prior excisional biopsy but she does not know which breast (35 years ago) No other morphologic abnornality. Several skin susceptibility artefacts are noted from reduction mammoplasty. Minimal background parenchymal enhancement. No abnormal mass or non-mass-like enhancement.
Left Breast: Dense parenchymal pattern. Minimal background parenchymal enhancement. Skin susceptibility artefacts from reduction mammoplasty. No morphologic abnormality. No abnormal mass opr non-mass-like enhancement.
Impression: Normal bilateral breast MRI

MAMMOGRAPHY CONSULTATION INTERPRETATION OF OUTSIDE IMAGES

HISTORY: 62 year old female for sugical consultation based on outside mammogram recommending excisional biopsy left breast. Mammogram indicates bilateral amorphous califications regional on the left and clustered in several clusters on the right with steroatacctic biopsy recommended on the right and open biopsy on the left.

FINDINGS: Available for interpretation is bilateral diagnostic mammogram with magnificatons views (digital) 11 MAR 09

Dense parenchymal pattern. Regional punctate and amorphous calcifications left breast 3 to 4 o'clock posteriorly. Several clusters of punctate and mildly amorphous calcification are seen on the right. No dominant mass or architectural distortion. The calcification on the right are stable. The calcification on the left, if at all have changed only minimally. It is difficult to compare between digital and analog images for the calcifications as digital imaging is more sensitive in detail for calcifications . In spite of the lack of change, the calsification on the left do warrant biopsy.

IMPRESSION:  Mildly suspicious calcifications left brreast warranting biopsy.

Recommendation: Excisional biopsy is the appropriate option. A stereotactic biopsy can be performed prior to excision in order to aid the surgical planning.

I did have the stereotactic biopsy yesterday and will find out the results on Wednesday. The Radiologist stated that even if this biopsy is negative, I will still need to have the excisional surgical biopsy. I do not understand why, if they do not find abnormal cells, they would need to go back into my breast and remove a larger piece of tissue if no abnormal cells were found... Can you explain this to me? Would appreciate hearing you thoughts.

Thank you,

[lesliebtq]

Thank you for your comments about my MRI and biopsy. Can you clarify what ADH is? I understand that ADH increases the risk of future development, and wonder what the intials stand for. Thank you. Hopefully,  I will get the results on Wed. and will let you know.
Leslie

[japdip]

After reading the reports as well as your posting I believe I would be more prone to follow the recommendation of the Breast Surgeon. Of course everything will depend somewhat on the results of the biopsy but a negative biopsy usually doesn't require further surgery. The MRI looks good to me ... this test is much more sensitive when dense breast tissue is present. The suspicious area that was biopsied may have indicated that this might be ADH and if this is the case then excision is recommended. This is NOT cancer but can increase one's risk in the future. This may be what the Radiologist was thinking about. Always get second opinions though if you have any doubt at all .... Regards ...