Breast Calcifications Biopsy

September 3, 2022 8:25 AM

I have a questions about breast biopsies and calcifications. More inside.

I went to a follow up mammogram/ultrasound yesterday and was recommended to get a breast stereotactic biopsy (actually bilateral) for micro-calcifications (I think). Although I am usually a huge hypochondriac and very invested in medical expertise, I almost wonder if this is overly invasive, rather than just waiting 6 months for another set of images. I read a previous question this morning about trying to interpret the technician's every pause and phrase and I'm definitely there right now... wondering. I've also read about over-diagnoses... but am also very worried of course. I'm even worried about all of the radiation involved with all of the images taken etc.

Does anyone have any experience with this?

posted by bquarters to Health & Fitness (4 answers total)

Just get it done. The procedure itself is awkward but not excessively painful. The waiting for the results is a nightmare, but these days in the U.S., usually a relatively brief one.

Because the lesion they're looking for (ductal carcinoma in situ) is relatively indolent, waiting won't help much. The calcifications may not have changed much in six months...unless it's one of the relatively rare DCISes that's ready to go ahead and start invading surrounding breast tissue, in which case you will have made the situation worse.

There is controversy about whether every DCIS requires surgery. From what I've read about the current state of knowledge, it's a well-founded controversy and under the right circumstances a person could reasonably decide against immediate surgery. But it's a decision you can make once you have the information. Also, if you don't want surgery, I think they're currently enrolling in clinical trials to compare it with observation only.

Sorry if you already understand this, but in terms of radiation a stereotactic biopsy is literally...another few mammograms. Obviously there's no desire to run around and get a lot of excessive radiation exposure, but we're talking about adding a few more to the near-lifetime you're already signed up for if you're planning to follow guidelines for regular screening.
posted by praemunire at 10:16 AM on September 3, 2022

I read a previous question this morning about trying to interpret the technician's every pause and phrase and I'm definitely there right now

Oh, just BTW...a technician can tell if there are suggestive microcalcifications (that's why they usually tell you that day), but except for a few outlying "configurations" it's really hard to tell prior to biopsy whether calcifications indicate cancer! It's not like some other form of cancer where the tech might see multiple big tumors or something. The calcifications are actually an indirect means of identifying that a cancer is present (individual dead bits and pieces), but a number of other phenomenon can produce the same results, including the very common and harmless breast fibroadenomas.
posted by praemunire at 10:24 AM on September 3, 2022

I had this done last year and while it’s not the most comfortable procedure, it’s not that invasive. Local anesthetic only, and to be honest, my first COVID vaccination was more painful and sore afterwards. It leaves a tiny mark, probably less than the size of a pin head, but that healed quickly. The whole thing took about an hour from start to finish, and it was completely worth it to know for sure what the mass was.
posted by Fuego at 11:54 AM on September 3, 2022

Hi I did it but to clarify in case anyone else has it done- it is not the procedure where you are face up and leave with a bandaid (as my friend told me the night before). I left in a compression bandage with icepacks and should really have had 48 hours recovery...(which I did not). The bruising (and blisters!!) surprised me. Don't have results yet though. The "just do it" advice was helpful, I moved my appointment to earlier than it was originally scheduled. Thank you to everyone who answered.
posted by bquarters at 5:48 AM on September 17, 2022