microcalcifications and surgical biopsy

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New Member

Date Joined Nov 2008
Total Posts : 1
   Posted 11/24/2008 9:37 AM (GMT -6)   
I had a follow up ultrasound mammo last week. The radiologist said he was going to recommend the microcalcifications (2 of them) be removed. My doc is going to refer me to a surgeon for a biopsy. Of course, all weekend I've been chewing my nails, waiting to actually be able to schedule an appointment to see a surgeon to see what the heck is up. I'm hoping you guys can answer a couple of questions!
1. Just because I'm being referred to a surgeon, does that necessarily mean "surgical biopsy" ? Or do surgeons also do needle biopsy?
2. How does one go about finding a good surgeon? I don't want a second-rate surgeon messing with me :) I live in Jacksonville, FL.
Thanks a bunch!!!!

Regular Member

Date Joined Sep 2008
Total Posts : 23
   Posted 11/25/2008 5:19 PM (GMT -6)   
Microcalcifications are very common in the breast.  When they are large enought and has a characterisitic appearance, they can tell that they are benign.  When they are too tiny and in a certain pattern (usually in a cluster), they can't tell what it is, and it needs a biopsy.  Overall, 80% of cacifications that are biopsied are benign. 
Biopsies are done in too ways.
1)  The most common method is called a stereotactic (core needle) biopsy).  This is considered a minimally invasive" procedure.  This has been around for about 13 years.  A radiologist usually does the biopsy.  You lay down on your stomach with your breast through an opening, and they do a mammogram to find the calcifications.  Once the calcs are found, the info is sent to a computer; and the computer gives coordinates for the radiologist to know where to go with the need.e.  A small (1/4 inch) incision is made for the needle to go through; and the needle cores multiple strips of tissue which get sucked out.  The specimen is x-rayed to check for the calcs and sent to pathology for analysis.  A metal clip is usually placed at the biopsy site. 
2)  The second type of biopsy is the needle localization surgical excisional biopsy.  There are two parts.  First, a radiologist will place a needle and wire through the calcs when you are in compression for a mammogram.  Second, you will be sent up to surgery, and the surgeon will take a lump of tissue around the tip of the needle.  The specimen is x-rayed for calcs.  This procedure is the "gold standard" or some would call it the "old standard" and is still performed when 1) stereotactic biopsy is not available, 2) the breast tissue is too thin for a stereo biopsy, or 3) the location of the calcs is not well accessible via a stereotactic biopsy. 
Sometimes a patient is referred to a surgeon first for a breast exam and history and physical; and the surgeon will refer you to a radiologist for the stereotactic biopsy.  Or sometimes a surgeon may want to just do the needle loc surgical excisional biopsy themselves since they can do this themselves (and can get paid for it). 
When you say you have two microcalcifications, do you mean you have two clusters?  Two clusters may require two biopsies depending on how far apart they are. 
Overall, don't worry.  Like I said, most (80%) of biopsies are benign. 
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