Expert: Claes-Gustaf Nordquist, M.D. - 9/1/2008

Question
My Mom is 52, post-menopause and she got her annual mammogram done recently. We have family history, my Mom's sister was diagnosed with BC at 47 and my grandma too had BC. The Radiologist gave my Mom's mammogram a BIRAD-2 for right breast that showed a " tram trak like calcification in the caudal view only ". The left breast was fine without any calcifications. This calcification was faintly seen in last year's mammogram too. When she showed it to her Dr , she straightaway asked her to go for fine needle aspiration cytology. I am concerned as to why did she say this, as BIRAD - 2 is generally not scary and tram trak calcifications are vascular calicifications thought to be benign. Is FNAC painful? Should we get second opinion about getting FNAC done or not.. I appreciate your reply. Thanks

Answer
Her dr. probably wants it done to be on the safe side since the lesion has become more prominent over one year. A BIRAD evaluation is a probability evaluation it is NOT a pathology report. A former boss of mine, the late Professor Dr. Sixten Franzén, M.D., Ph.D. was one of the pioneers of the fine/thin needle aspiration biopsy technique (the instrument he invented for doing such biopsies of the prostate in males is still called the Franzén instrument) and I have myself used this technique extensively over the years. It is not dangerous and it is not more painful than any simple injection! It is never wrong to have second opinion but have the biopsy done too! Good luck!