Expert: Claes-Gustaf Nordquist, M.D. - 8/14/2009

Question
QUESTION: I had a mammogram that showed a couple of calcium deposits in my left breast. Subsequently, I had a biopsy (Core); it was discovered that the cells were atypia. A metal identifier was placed in my breast where the tissue was removed, as the doctor stated that if they had to go in again, it would be easier to find the location.

Next, I was told the tissues weren't cancerous, but were atypia cells; it was recommended that I remove the small calcifications (very small, not palpable) because, within 5 years may turn cancerous. I declined, due to the fact that I keloid very badly and they aren't cancerous nor big.

6 months later I had another mammogram at a different hospital and radiologist, and when the two mammograms were compared they noticed new "activity" in the area, but still nothing in the right breast. They haven't explained what they mean by new "activity", however, my primary care doctor suggests I come into the hospital to speak to the specialist about the new "activity" and have a fine needle biopsy completed.

I am wondering if the new "activity" could have anything to do with the metal that was placed in my breast. It has been itching and bothering me ever since it was placed inside of me (against my wishes). As I had told the doctors before the metal was placed in my breast, I am very allergic to many things that come into contact with my skin.

Otherwise, what exactly do the doctors think is the new "activity" and what does this mean for me; what should I be prepared for with the fine needle biopsy? What type of buzzwords will be thrown around? My appointment is in 3 days. I do not have a history of cancer in my family; however, I lost my 57 year old  father to squamous cell carcinoma (under his tongue) 6 years ago.

Thank you for taking the time to respond to my lengthy submission, have a great day.


ANSWER: The metal clip is made of titanium the most living tissue friendly and non allergic metal available. It is also necessary in order to KNOW exactly where the sample was taken from. The new "activity" indicates changes from what it looked like before. And that is always a warning sign. A fine/thin needle aspiration biopsy is no more problematic than an injection (though in reverse, instead of injecting something into you a specimen of tissue cells are sucked out from you for examination). It is quick, easy, simple and almost painless (no more than an ordinary injection). It is like a gynecological smear a cytology examination (cells only). You should have it done. But I also strongly suggest that you have your lesion surgically removed due to its change as already suggested to you by your dr.!


---------- FOLLOW-UP ----------

QUESTION: Thank you for your quick response and clarification of the fine needle biopsy; however, you weren't very clear in defining "warning sign". You stated that this is always a warning sign; for what? Cancer? If so, how soon? What is the process of removal of lesions? Is it really invasive? Is serious scarring involved? What about my right breast, is it possible for things to start happening over there as well? What is the success rate on these removals? Thank you for your time in answering these many questions.

Answer
By warning sign I mean a sign that a cancer may be developing or even may have developed/may have been missed earlier. No time tables can be given. The earlier such a lesion is removed the better it is, the higher are the chances of a cure, the less is the risk of an invasive process and of any scarring and the higher is the chance of success! At the moment there does not seem to be any problem in your right breast. What will happen there in the future remains to be seen.
Good luck!