Expert: Claes-Gustaf Nordquist, M.D. - 12/15/2006

Question
Hello:

I have had bilateral microcalcifications as long as I've been having mammograms (about 20 years) These show the "milk of calcium" appearance which I understand indicates they are most likely benign. I have never been concerned about these.  However, one year ago I developed another area of microcalcifications in the right breast which do not show this milk of calcium. Doctors have been following this for one year (3 mammograms) and there has been no change.  I'm concerned because they didn't comment on them with the third mammogram (which was supposed to be a followup) but diagnosed an area on the left breast that they think is a lymph node .Recommendation is a 6 month followup. Could the suspicious microcalcifications in the right breast disappear after one year?   

I have been reading about DCIS and how it often first appears only as microcalcifications. I have also read that in the past this condition was often followed for years which tells me that no change in one year is not that significant.  (this seems to be the basis for the opinion that there is no reason for concern)

Every doctor I have spoken with (other than a breast specialist) has told me they don't think I have anything to worry about but from what I've read, I'm not convinced. I want to see a breast specialist but I am meeting a lot of resistance.  

How do doctors decide which microcalcifications (that do not show the milk of calcium appearance) need to have more testing or biopsy?

thank you,

Chris  

Answer
No one can be sure if such lesions as you describe (the more recent ones) are benign or malignant. Instead of waiting for things to happen I therefore strongly suggest a needle biopsy - if necessary stereotactically - so a pathology report can tell what it really is. Ok? In order to get it try to get a second opinion!