Sunday, May 17, 2009

A second mammogram required; questions answered

Pleased to have this task completed in less than 15 minutes after arrival; I was feeling pretty cheeky as I left the clinic this year after my annual mammogram. Unfortunately, I would receive a call later that day informing me additional images were needed. I would undergo a second mammogram and ultimately a biopsy. To my relief, I ended up having a benign breast calcification, not cancer. As I look back on this experience, which was pretty surreal, I realize I had quite a few questions throughout the process. I will now attempt to answer those questions with the intention of helping others in a similar situation.

How common is it to be called back for a second image?
About one in ten mammogram screenings result in a patient being called back for further testing. Most likely this call back is not due to a bad image, but because the radiologist saw something that looked suspicious and wants a better view. The second screening is a magnification or a compression view where they zone in on a specific area or an ultrasound that will give information like is it a solid area or just a more dense area of tissue or if it's a cyst.

What was seen on my second diagnostic image?
The radiologist saw a calcification on my left breast that had not been present on prior images.

What are breast calcifications?
They are deposits of calcium in some areas of the breast tissue that show up as white spots on a mammogram. They cannot be felt, and are only detected on a breast mammogram. They are very common and in most cases harmless.

There are two types:
Macro-calcifications are usually larger, fewer in number, widely dispersed, and round. They are harmless and need no treatment or monitoring.

Micro-calcifications are specks of calcium that may be found in an area of rapidly dividing cells. When many are seen in a cluster, they may indicate a small cancer. About half the cancers detected appear as these clusters.

What causes breast calcifications?
Calcium can be deposited in breast tissue for a variety of reasons, many of which are not related to cancer. Some benign causes of breast calcifications include inflammation from a breast infection, and injury or trauma to the breast. Calcium deposits may also be included in a benign breast cyst or a benign breast growth like a fibroadenoma. Taking calcium pills does not cause them. Also, there is no known link between calcium intake in diet and the formation of breast calcifications. Nor has a correlation been found between post-menopausal hormone replacement therapy and the development of breast calcifications. Calcifications in breast tissue occur most commonly as a natural process of aging. As we age, there is some degeneration of tissues and this can cause calcifications. Hence most women develop calcifications as they grow older. The cause which worries women the most is of course cancer. But cancer as a cause of breast calcification is quite uncommon compared to the high proportion of calcifications seen due to other causes. Cancer is suspected only in some specific patterns of calcification.

Why a biopsy?
The way these calcifications are positioned within the breast and their number and shape can provide the radiologist with an idea of whether these should be left alone or further examined for invasive or preinvasive disease.

My radiologist explained there are three possible determinations he makes based on the shape of the calcification:
1. A mass that is star-shaped or irregular is serious.
2. A round or smooth-edged mass is more likely to be a fluid-filled cyst and not serious.
3. Calcifications that are hard-to-tell he deems indeterminate. Of course, mine was indeterminate.

There are two approaches to dealing with indeterminate calcifications:

A wait and see approach ~ I would return in six months for a follow-up mammogram to see if the calcifications have changed - a sign that a cancer could be growing.

Perform a biopsy ~ This is the only way to be absolutely certain the calcification is benign. Whether or not to do a biopsy depends on the radiologist's level of suspicion. When suspicious micro-calcifications appear on a mammogram, but no lump is felt, a needle localization biopsy is recommended, so that breast tissue can be removed and examined under a microscope by a pathologist. Some radiologists recommend the aggressive approach when dealing with indeterminate calcifications, recommending a needle-localization biopsy to see whether malignancy is present.

Because the deposit had not been present on prior mammograms along with the indeterminate positioning of the calcifications my radiologist strongly recommended a biopsy.

What actually takes place during the biopsy which is called a stereotactic core needle biopsy?
The radiologist removes small slivers of tissue containing the “suspicious” calcifications through a thin, hollow needle. This procedure is done using a special table and computer guidance device. A stereotactic core needle biopsy requires only local anesthesia (the patient is awake and alert) and the tissue can be sent to the laboratory for analysis without surgery.

My biopsy went well; the radiologist was able to remove the entire mass of calcifications. Afterward, he indicated he would be surprised if the biopsy results did not come back benign. Also, he was pleased to have been able to remove the entire deposit.

What percentages of biopsies are benign?
Around 85%. Calcifications themselves are not cancer but may be present in the midst of a cancer. Clustered small calcifications alone are associated with about a 25 percent risk of cancer.

Final thoughts on the ordeal:
~I didn’t get rattled, but I was anxious. To help ease the anxiety, I rescheduled both appointments to earlier dates as cancelled appointments became available. If something was seriously wrong I wanted to know as soon as possible.

~ I asked as many questions as I could of family and friends who had undergone the same procedure to give myself some idea of what to expect.

~ My sister, who is a radiologic technologist, gave me the following advice which did wonders to reassure me everything was going to be fine even if the calcs were malignant:
Calcium deposits also called micro-calcifications can be a very early sign of a cancer called ductal carcinoma in situ. If this is the case, would be easily treatable since it is so early.

~ Now that the bills are coming in (this procedure cost close to $5,000, of which my insurance company will pay 90% after I meet my deductible), I can't help wonder if I should have gone with the wait-and-see approach. My sister strongly disagrees with this statement insisting I did the right thing following the radiologist's recommendation.

~ You can’t take aspirin seven days prior to the biopsy and for three days following, but you can take Tylenol. I wasn't informed of the Tylenol option until after I developed an incredible migraine and pleaded with my breast care coordinator to allow me to take some type of pain reliever.

~What do you wear to a biopsy?
As I prepared for my biopsy, I couldn’t help think what does one wear to a biopsy; do you go for style or cheering up? I ended up going with worn and comfortable. I thought this was kind of weird thing to think about until I read in his book Chasing Daylight;Eugene O’Kelly wore golf clothes to his radiation appointments to get in a good mood as if he were going to play a round.

~During the procedure, the breast care coordinator stood next to me talking me through the procedure. I appreciated this diversion.

~The biopsy itself hurt. My back and neck got stiff. Also, the recovery wasn’t pleasant for the first couple of days. I had to ice the area every four hours and could lift nothing heavier than a jug of milk. Even moderate activity produced bleeding. Plus, I am still black and blue and the procedure was three weeks ago.

~Despite all of the favorable assurances I received, it was an incredible relief to know for sure it wasn't cancer.

~ And lastly, if you need to let a patient know their lab results are going to take longer than anticipated do not start the conversation with: “I HAVE BAD NEWS.”

106 comments:

  1. Louise G10:00 AM

    This is a really useful patient persepective, and gives an obviously well researched view. I am a breast radiologist, and generally take the more aggressive early biopsy route - yes it can be very scary, but alleviates doubt rather than waiting for 6 motnhs to see if things change.

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  2. Ronni6:18 PM

    Love the blog…here's the deal, check out (www.ThePatientsAdvantage.com); seriously. I ran into them looking for breast lift surgeons. They have a great way to find the best surgeons and it is completely free. I have used them a couple times now.

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  3. Thanks for posting this. I have just had the exact same diagnosis and after a consultation with the surgeon today, have decided to be aggressive and go ahead with the biopsy. I have been confused as to what approach to take, but am feeling better about choosing the more proactive choice. Even if there is just a small chance this is cancer or pre-cancer, I'd hate to give it 6 more months to grow. Again, thanks for sharing your experience. It truly helped.

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  4. Anonymous6:32 PM

    Hi, thanks that was good to read. I just had a core biopsy, and am anxiously waiting for the results (takes one week to get results, at least here in Victoria BC). I was not given the option of "wait and see" -- I was told that if the biopsy shows no malignancy, then I'd go for another mammogram in six months to check that there are not more calcifications.

    The biopsy hurt and was uncomfortable because I had to hold some awkward positions for long periods of time. The small incision will still give a tiny spot of blood if I do anything heavy - vacuuming, weeding, lifting, etc - and this is five days later. Almost better though... The bruise is still quite big.

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  5. Anon -
    Thanks for sharing your experience. If you are up for it keep us informed of the outcome.

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  6. Thanks for this insight. I was just (yesterday) called back for more images, but the clinic couldn't see me until over a month from now. I did not feel as though I should wait that long....for all kinds of reasons, and am going for another mammogram closer to home. Evidently, the clnic has TONS of paitents so that it is at least a month before you can get in...even on a call back. My health, my body, my responsibility, and if I can get the info sooner, I will. I am prayerful and hopeful my situation turns out fine, but I sure didn't want to have to wait over a month to know. I was so thankful to find your blog...I just knew, based on everything I've read and hear so far, there was someone out there who had the same experience and was making it a point to help others...just seeing your experience is helpful. I think the thing that compounds my worry is that the clinic couldn't see me any sooner. :(

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  7. Mclinson,
    It is definitely worth your peace of mind to get in as soon as you can. Good luck to you. Keep us informed of the outcome if you are up for it.

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  8. Thank God for miracles! The clinic that only yesterday couldn't get me in for five weeks, called early this morning to inform me I could come in today! Had additional images, ultrasound, consult with the Doc., and she said the words all of us desire to hear...."Everything looks good." I'm not sure what she said after that, as I began to cry with great relief. This episode in my life has transpired in the last 48 hours, and I have learned a great deal. I've learned more about mammography, that's for sure. I've also learned things about out healthcare system, both good and bad. I am reaffirmed in my belief that God allows us to experience things for a reason....maybe it's a reason that we don't understand yet, or maybe it was immediate. All I know is that my friends suppported me in prayer and encouragement, and I found Savvy Working Gal's blog which encouraged me...heck, I may even write my own little blog now. All I know is I'm thankful. My teenage daughter's messy room isn't such a big deal now. :)

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  9. Mc -
    I am so happy for you and so glad you were able to get in for that second appointment so quickly. What a relief.

    Also, I highly recommend you start your own little blog. I find the whole blogging experience to be very cathartic. If you decide to do so, let me know I'll be your first reader.
    LOL

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  10. Will do! Thanks again for writing on this subject...it was an important portion of "just what I needed" in this situaiton. :)

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  11. Anonymous10:12 AM

    Skookum said:

    I am awaiting biopsy results on my calcifications. It turns out that
    I can't remember exactly when I dropped some heavy object on my right breast within the last 7 weeks. I had a bruise for three days after this. I don't know how LONG it takes calcs to grow. I also had a clean CT chest scan a mere two months ago before the accident and I wonder why the CALCS weren't mentioned then.

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  12. Anonymous3:31 AM

    This comment has been removed by a blog administrator.

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  13. I just got a call from an unknown 'mammography coordinator' at a clinic other than the one where i had my mammogram. I'm nervous! It came while we were on vacation. I assume they saw something and need another set of films. Like you, I was 'cheeky' as I left the appointment last week! Thanks for the info. I feel a little better now.

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  14. After reading you story I feel like I am walking in your footprints. I too elected not to wait and will be undergoing the biopsy in the morning - I am scared of the procedure, but most the outcome. The Radiologist wasn't too upbeat while explaining that my mammogram was in the "grey area" and the possible reasons for changes since my last mammo. 12-08. He mentioned trama as one of the possible causes - I asked if a seatbelt could cause such an injury (major accident 7-09) his response was "Absolutely" and was then I was given the option to wait the 6 months. I too didn't want to take the risk and opted for the biopsy.

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  15. cigramma8:41 PM

    I got a call today to go for a second mammogram at the hospital I am now a nervous wreck what a horrible feeling but it made me feel better after reading these comments

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  16. Anonymous3:39 PM

    I received a call today to come in for a second set of films of my right breast. Like you, I had my mammogram last week with no worries. I elected to have it because I have scheduled a breast lift and augmentation in a month. I was just trying to be extra careful before the surgery, if you know what I mean. I am 46 and I have had screens every year since I turned 40. This is, however, my first digital screening. The radiologist is trying to compare it to the "old fashioned" films. I suppose I should not worry too much because the nurse stated "he needed more films to compare it to". I am hoping for good news. I suppose the breast lift and augmentation or not such a good idea now?

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  17. Anonymous7:34 PM

    Thank you. I have been called back for a second mammogram and my fear is all around the 'not knowing what to expect.' Thanks to you, I now have a much better idea.

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  18. Anonymous1:47 AM

    I recieved a call this afternoon ( 5 weeks after my anitial mammogram)
    My sister has just been diagnosed with stage 4 lunge cancer so as you can imagine i am very worried, we don't have much in the way of family hostory, so now i just wait & worry. Do i tell my family & worry them to or do i wait for the results?????

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  19. Anonymoous,
    Five weeks seems like a long time after your initial visit for a call back. I'm not sure what that means.

    I would seek out a trusted friend and discuss your fears rather than telling your family at this point. There are so many reasons why the need a second set of pictures, why worry them needlessly, but then this is just my humble opinion.

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  20. LR Ottawa12:18 PM

    Just got my call for a second mammogram - have to admit it put a knot in my stomach. Good to read this blog. Hope it turns out to be nothing too!

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  21. LR Ottawa,
    Good luck. I hope it is nothing too,

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  22. OK - I received the same call today; got to go back for a second mammo. I have worked myself up into a tizy worrying. I know my OBGYN told me during my last checkup, that I do have those fibroid thingys in my breast. Is that the same thing that you refer to as calcifications? I go back Thursday for the second, then I quess I'll have to wait another few days for that result. This waiting is torture!! God's Word tells us that whatever He takes us to, He will take us through!!! I just pray that He isn't taking me to anything right now. Also, that He will relieve me of some of this fear of the unknown. Please keep me in your prayers as I will those of you who are still waiting. And if you can give me any insight to my situation to help relieve some of the anxiety, that would be wonderful!!!

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  23. Anonymous9:20 PM

    I am going in for my second mammogram tomorrow. I know a few woman that have gone back a a second time and had no problem. Just a total nervous wreck tonight. I am praying it is just age and change of life going on. Wish me luck!

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  24. Me too. Got my call today, and fortunately for me (I guess?) can go in tomrrow for more pictures. THANK YOU for posting this blog, as I was poking around on the internet looking for any information on this second-call thing. I'm a little nervous but not overwhelmed, at least not yet.

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  25. colleen8:54 AM

    I go Friday for a second mammogram as they said I have density in both breasts that wasn't there on my last records (2 yrs ago). I am nervous but started heavy exercise about 6 months ago and I really feel that all the push ups & weight lifting, plus wearing tighter exercise bras may have resulted in my breasts being denser....is this a possibility do you think?

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  26. Libba,
    I am not a medical professional, but I believe calcifications are not the same thing as fibroid thingys.

    Colleen,
    Again I am not a medical professional, but I don't think heavy exercise or tight training bras would result in denser breast tissue. Aren't the pectoral (chest muscles) underneath the breasts. If you find out differently when you visit your doctor, stop back in and let us know.

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  27. Thanks for posting this information. My mother was just called back for a second mammogram and finding this post on your blog helped allay the fears I had about what exactly was going on.

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  28. Anonymous12:55 PM

    on thing you didn't mention was the apparently routine practice of leaving a titanium marker in the breast permanently as part of the biopsy. This marker or chip has been known to cause allergic reactions in women and pain in others. If I ever need a biopsy, I am going to refuse the marker. Let's put it this way: there are a lot of things to consider and think about and know about before rushing in to get a biopsy. I highly recommend that women educate themselves fully before doing so. Most women know nothing about this marker jazz. It's just an indicator of how often we the patients aren't fully informed, or we are informed in a rushed manner a few minutes before the procedure. That doesn't work out for me. And always remember it is your body and your option to not have the marker placed. If the radiologist argues with you and presses you about it, go elsewhere. We still do have some rights and choices and options and none of us should ever forget it. thanks.

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  29. colleen1:51 PM

    PTL My second mammo came back negative!

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  30. LuAnne9:25 PM

    Just got my call this afternoon. I am out of town until next Weds. So I have to wait until then. My mother had breast cancer at 43, and I am now 44 and this has freaked me out. Esp since they just want to look at the right breast. I will try to be positve until then and will check back in and let you all know. Thanks for a great blog... it really has helped!

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  31. Anonymous12:02 AM

    I got the call to go for my second mammogram Each time I have went in and have been tested I wait on that letter , to come back or not to come back. The letter came this time said to come back for a second look on my right breast. I couldn't get back in till Nov 9. I LOST MY MOM TO BREAST CANCER 29 YEARS AGO SHE WAS BEAUTIFUL AND 50 YEARS OLD Im 55 NOW . hAVE BEEN DREADING THIS 29fff YEARS. i
    KNOW THINGS ARE SO MUCH BETTER NOW. I will overcome this. Kay

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  32. Cherie12:26 PM

    I'm an 8 yr breast cancer survior. I had it in the right breast at 36 yrs old. I had micro califications and found out by biopsy it was cancer. I was very lucky it did not spread its was stage 3 because of the tumor size had a lumpectomy and chemo w/ brachy radiation. Yes most of the time calcifications mean nothing. I just got called in for 2nd mammo and ultrasound on left breast now. I can only hope it's not back. Always a worry on my mind this site reading has helped me feel a little less worried. I know one thing I would never go thru chemo again.... Good luck & God Bless everyone. Cherie

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  33. RS in WI11:26 AM

    I went in for my yearly this morning and was just called. The nurse began with"I am so sorry..." so that right there sends me in a panic. After reading what you wrote, I feel better. Thank you for all the valuable information!
    Sending a prayer to all women who receive that phone call that they have to come back in.

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  34. I was called back today to have my mammogram repeated. They said it looks like there was "a little movement" and when could I come in. I said, how quickly and she said, can you come today. That freaked me out. I went and had the left breast done, just the sideways view and they had me wait in my gown in some odd room. She said the radiologist was there and would read it if I wanted to wait. Five minutes later, the woman who did my original (and first ever) mammogram came in and said I could go. I asked, "What about the results?" and she said, "Oh we cannot give you those. We have to send the images to the main hospital. We'll be in touch. Happy Holidays!" Happy Holidays indeed. So now we wait again. I'm so glad I found your post. It made me feel so much better. I don't feel any lumps, so I know even if it is something, it is early. I am glad you described the needle biopsy as well. Many thanks to you and I hope everything is ok with you.

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  35. TF,
    Making you wait for your results 'til after the holidays that is just cruel. I hope it was just a fluke and everything will be fine.

    As for an update on me; I’ve gone in every year since this procedure for my annual mammogram and all have been clear.

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  36. I had my first mammogram two weeks ago, got a call back to come in gain for more testing. Went in yesterday had additional mammogram with several taken two times coming back into room, then went in for ultrasound. I asked to see the area on the mammogram and could clearly see what they were looking at. The ultrasound technician said she could not see anything like they were looking at in the mammogram. They told me i will be back in six months and to go see dr. for results.

    My sister is going through breast cancer treatment right now she is 48. When she was here last April she had me feel this area on her left upper breast. I did and it felt diferent..not pea shaped...just different. She said I just had my mammogram and they said come back in six months. We both have dense breasts. She found another lump this one pea shaped on her right breats about five months later. Went to dr. and went in for a mammogram...this time the left breast area she was concerned about clearly showed itself. Went for MRI to get clarification and of course her biggest fears come true. Breast cancer runs un my family.

    Going to mr dr. on Monday and I am all confused. Do I wait six months like her.....or do I ask for MRI and get put on their waiting list (not sure how long the wait is).......or do I go the private route and pay for an immediate MRi? a private

    to show nothing

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  37. I learned a lot through your post. I am so glad you are OK! Thank you for sharing!I am coming from the Lighting and The Lighting Bug link up.

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  38. I feel a great relief after reading your post. The nurse warned me I may receive a second call and asked not to worry but of course a second call creates anxiety and of course I worry. It's comforting to know it is normal for me to have these feelings and to find such great detailed information to ease the anxiety.

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  39. Anonymous6:56 PM

    My wife just got a call to come in after 2nd mammogram. We are in panic mode, but reading your posts really helps.
    God Bless you all.

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  40. Awesome post! Thank you all for sharing! I go in Monday for a needle biopsy to remove 10 micro-calcifications that are irregular in shape & clustering. My compression x-rays & ultrasound both look good but I know that irregular shapes that cluster together can also be the early signs of cancer. My question is to the number of micro-calcifications. Does it play any role or have a factor in this equation? If there are any of you who don't mind, would you please tell me the number of micro-calcifications that you had removed?

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  41. Had a routine mammogram last week. Just got a letter saying I had to come back for second screening and my doctor should have the report. He doesn't. When I called the hospital, the nurse said I could come in Monday so that I could talk to radiologist. This has me very scared because I have never talked to the radiologist before. She told me they need to magnify an area. Does talking to the radiologist mean they have already determined there is a cancer? I have an anxiety disorder and of course this isn't helping. Any words of advice?

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  42. I had routine mammogram last Saturday (I am 69) Received a letter yesterday that said I had to come in for more screenings. My doctor had not received the report. When i called for informnation, the girl told me the radiologist would speak with me after the second screening. This has me really worried because I have never spoken with radiologist before. I go Monday for second screening and am really scared. I can't feel anything. I did have a biopsy on right breast for skin cancer a couple weeks ago and scab is still there. I have anxiety distorder and this isn't helping. Any words of encouragement?

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  43. Alma,
    Being asked to meet with a radiologist does not mean they have determined you have cancer. They absolutely have to perform a biopsy on the suspicious area before they can determine anything. What it does mean is that the radiologist saw something out of the ordinary on your mammogram. In your next appointment they are going to take magnified pictures of the area in question. They will then discuss your options which may then include a biopsy. I would concentrate on relaxing this weekend. There is still a good chance this is nothing serious.

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  44. Alma,
    After receiving your second comment, I am sticking with my above advice to try and relax. The good news is they are only making you wait 'til Monday. I know many women including myself whose second mammogram was scheduled several weeks out. Also, I did meet with the radiologist after my second mammogram. He went over what he saw and gave me my options. I still say you should get out the bubble bath or book a massge. Be good to yourself 'til Monday. It is still too early to worry. Then be sure and come back and let us know what happened. I am hoping for the best.

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  45. Thanks for your information it helps ease my mind! I got a call back today for 2nd mammogram. Radiologist noted changes from my last mammogram a year ago. Still, I am scared! This is my third annual mammagram and the first time I have been called to come back.

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  46. Savvy Working Girl

    Went for my second screening today. There was an area of density that the radiologist wanted to review. They did images from different perspectives and results were OK. Technician said the second screening pressed out the dense area so that a better view was possible and everything was fine. Relief. Thanks for your input and support.

    Alma

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  47. Jen,
    I hope your 2nd mammogram is a false alarm. Many, many women are called back for more images. More often than not the radiologist just wants to take another look from a different angle. Usually it ends up being nothing.

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  48. Alma,
    Thanks for letting me know the results. I was worried about you. What a relief. I am glad they got you in quickly and were able to let you know immediately everything was fine. Good luck to you.

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  49. Trina P7:37 PM

    Just(got my letter on the weekend) had my second mammogram and compression views and showed two areas in the right breast with several clustering microcalcium deposits. I could easily see on the pictures a few Macro deposits but the two clusters of the micro type bothered the radiologist. He gave me the option of waiting but I figure sooner is better for finding out if it is or isn't. If it is then take care of it now. If it isn't the stress of worry is lifted

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  50. Anonymous3:31 PM

    They called today and are getting me in tomorrow.
    I just had an endometrial biopsy and have not gotten those results back yet. I am very upset as you can imagine.
    Mine has "jagged edges", and when I Googled it, it is suspicious.
    $5,000.00 is a lot of money, and I also have to pay a deductable since my insurance only allows this test once a year.
    Has anyone in this thread, had a second look and ended up with breast cancer? If not, then I am feeling a tiny bit better.
    leaving for vacation June 13th, so I am going to be bleeding while I am suppose to be having fun.
    Thanks so much for this blog.

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  51. Anonymous,
    I too have wondered if anyone who has stumbled across this blog post actually has breast cancer. If you do and are up to talking about it, please share your story. If you would like to write a guest post or be interviewed by me please email me at savvyworkinggal@hotmail.com. My purpose is to help as many women as I can and I think sharing our experiences does that. Thanks everyone.

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  52. Carol in NC10:45 AM

    I too, am having a breast biopsy next week and am very concerned. I'm already having two chemos (9 hr treatments) for leukemia and Lymphoma at Duke Medical Ctr and can't imagine that I would have to deal with breast cancer too. Do any of you have other cancers? Reading these comments make me quite nervous. For one, my abdomen still has a grapefruit size mass and I can not imagine having to lie face-down for 20 or 30 minutes. also, knowing that the biopsy apparently really hurts frightens me...I'm in too much pain already. Anyway, I guess my question is, have any of you dealt with this while you were already on chemo for a different cancer?

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  53. Anonymous6:56 AM

    109Thanks for sharing, it helps to keep things in perspective. I was called back, giving me a next-day appt.,in itself a bit scary (why so quick when there is a waiting list?) After the second mammogram I was aked to have an ultrasound and I saw for myself the tiny grey mass. I opted for the immediate needle core biopsy, not to wait six months and am now waiting for the results, trying to stay positive and not panic. I am sure things are going to be alright, but a little part of me is still worried. I am alone, no family at all and don't know if my friends would really fit me into their busy lives if there actually was something wrong. I think that is the worst part. Hurry on next week with the results!

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  54. Anonymous10:09 PM

    Thanks for sharing. I too got called back for a second mammagrM which is leading to a biopsy for calcifications. I am a nervous wreck. I had a breast reduction two years ago and sas wondering if that qualifies for the trauma some of you were referring too

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  55. I have found your blog and it is helping but I too have to get a second mammogram. I had rectal cancer in 99 and went thru the removal, chemo, and radatiion. I am so scared and hope for the best cause I am not sure i will go thru chemo again. I am hoping for the best and they don't find anything wrong. thanks for the info and pray for the best. Dawn

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  56. Anonymous,
    I found a good answer over on http://www.empowher.com/community/ask/can-trauma-breast-reduction-cause-breast-microcalcifications. Cary Cook gave the following answer:
    Surgery could irritate the breast and irritation can cause microcalcifications. However, many women have these and have not had surgery, so it might be difficult to be sure of cause and effect.

    We have some information here on the site: http://www.empowher.com/condition/breast-calcifications
    and another nice little article is here: http://www.mayoclinic.com/health/breast-calcifications/MY00101/DSECTION=...

    Good luck to you.

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  57. Dawn,
    It sounds as if you have been through enough. I am praying for you. Try to stay as strong as you can. Good luck.

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  58. Anonymous10:22 AM

    I had my routine annual mammogram on Monday.....on Tuesday, my doc called me and said I would need to go back in for more views. He added that he did NOT want me to lose sleep over this and that most likely it is just fibrocystic breast tissue.....an issue I have been dealing with on and off for a decade. It is still very nerve wracking for me. I always assume the worst and hope for the best. Don't like that I do that, but it's how I'm wired. I was feeling some sense of relief in the fact that they said they could do the second set of images a week from now......in my mind, that means if if WAS cancer, they would have me in there ASAP, but after reading all these comments, it doesn't sound like that is the case....it sounds like sometimes you have to wait weeks and weeks to find out.

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  59. Anonymous3:02 PM

    I go tomorrow for a magnification of my left breast.This is the first time I have ever been asked to come back. I am 61 yrs. old and of course very upset . I was told there is calcifactions in my left breast, since it was ok last year, this puzzles me because I was first called and told that I had received the wrong letter, my sister-in-law and I went together and with the same last name, even tho she has inplants. She has not received any results back yet. Then later the same day, I was called and told it was mine. They said the chart #'s were written down wrong. I could go back for a reg. mamm, but decided to go for magnification to be sure! Does anyone know the difference in cost, as my ins. will only cover 1 a year, and my deduct. is quite high? Have had enough stress for a lifetime.

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  60. Anonymous9:18 PM

    This was an extremely useful post. I was recently called back for a 2nd mammogram. After reading your post I knew what to expect, and it went exactly as you described. I had to wait a week for an apptmt. I had what they thought was a fibroadenoma. These are solid masses that 90% of the time are benign. They usually form when a woman is in her teens and 20s from excess estrogen. If undiscovered at that time the next time they are seen is when a woman is in her 40s getting her first mammogram. I could see it as a small spot on the mammogram. They did multiple scans of which some were magnified. They then moved me to the ultrasound. The mass looked oval shaped with a dot in the middle of it. The radiologist recommended biopsy because while he thought it was a fibroadenoma, mine was not perfectly oval, one side had a border that was uneven. I was given no other options due to that uneven border. The dr said it was smaller than a pea (though some can grow much larger). It could not be felt on me. I went for the biopsy three days later. It was not bad. They redid the ultrasound and made a mark where the biopsy needle would go in. They draped me and disinfected the area. Then they gave me 3 shots. I only felt the first one, and the needle was very fine so it only hurt a little. They kept the ultrasound on so they could see the mass. They did a core needle biopsy with vacuuming, therefore the machine is loud, does some vibrating, and has a slight burning smell. The needle is long. You can hear some suction. They told me it came out easily. The dr told me he felt it was benign. They put in a small stainless steel clip to know the spot in case it came back malignant. The nurse applied hard pressure for about 10 minutes. There was some bleeding. I then had 3 follow up mammograms so they could make sure it was all out. They then bandaged me up and gave me a small gel pack. It took one hour, tho they said it can take up to 2 hours. I came home and put frozen peas on the area (over my clothes) for 15 minutes on and 15 minutes off for 3 hours. They offer Xanax or Valium for those with anxiety, but you have to have someone drive you. I was told I could not lift anything for a day and not to exercise. It has been a day, the dr called and thankfully it was benign. The area is sore, but not unbearable. If it had been cancer, I would have had to go back in and they would have placed more pins to guide a surgeon for additional removal. As is, I do not have to return for a year. The pin will help them monitor that location. I wish all women well that are undergoing this and experiencing this fear. I do not know the cost yet. I will post cost info when I get it. The first mammogram was free with insurance and the second set cost me $150 with insurance, I have not been charged for the other procedures yet.

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  61. Anonymous wrote:
    ......in my mind, that means if it WAS cancer, they would have me in there ASAP, but after reading all these comments, it doesn't sound like that is the case....it sounds like sometimes you have to wait weeks and weeks to find out.
    Anonymous,
    That is not true. If they strongly suspected you had cancer they would have you come in immediately and you’d have your results in a day or two. During my last mammogram I told the technician who popular my post was and how scared my readers were about having 2nd mammograms. She said if the radiologist suspected that I had cancer he would have me come in for an ultrasound right away. I hope this helps to calm your nerves a bit.

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  62. Anonymous wrote:
    Does anyone know the difference in cost, as my ins. will only cover 1 a year, and my deduct. is quite high? Have had enough stress for a lifetime.
    My last mammogram was 6/8/12. It cost $141.00. My insurance policy covers one mammogram per year. It is not subject to deductible or co-insurance.

    I would call your insurance company, explain your situation and ask how it will be covered.
    It would be helpful if you would stop back in and let us know what happened.

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  63. Anonymous:
    Thanks so much for sharing your experience. It is so helpful. I am also happy to hear you did not have cancer.

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  64. thank you so much- am heading in for follow up diagnostic mammography and ultra sound tomorrow. your info really helped to put my mind at ease. thank you. xoxoxo

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  65. Two weeks ago I went for a routine mammo last week they wanted a second. This week they told me indexed a biopsy. I am 52 and stopped having my period 18 months ago. 2009 was my last mammo and there was no sign then. The second mammo report as follows: small cluster wich vary in size but similar in density.... Indeterminate. I have refused the biopsy until I speak to the surgeon and if necessary the radiologist. Lost my sister 10 years ago to BC. Her biopsy caused the cancer to seed and it rapidly spread and she was gone in 6 months. Any words of advice?

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  66. Khamir,
    My only advice is to talk to your surgeon and do whatever he recommends. This is a scary time and nothing can really reduce the anxiety like knowing the facts and your options. Good luck.

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  67. Anonymous8:28 PM

    I'm the person who had the adenoma and posted earlier. I said I'd post cost info. It was about $2,000. This included the repeat mammograms and ultrasound, then the biopsy and additional mammogram.

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  68. Oh wow, so glad to of found all of you. Went in for mammogram on Tuesday and received phone call yesterday (Thursday) that they wanted me to come back in to do another mammogram and possible sonogram between Mon-Thurs. Reason was left breast showed differences from last sonogram done Jan 2010. I am scared. Trying not to be but still scared.

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  69. Anonymous11:42 PM

    Hi blenda2u,
    I had a mammogram last Friday and got a call to come back in because they found an area of density in my right breast. I will get back there Wednesday morning. It is Monday now. I believe you will be just fine. The vast majority of the time, you get good news after your follow up . I have had this happen before, and it is very easy to get alarmed. But honestly , worrying does not help and MOST of the time you are fine. Dr.s have to check out all possible causes because we live in a very litigious society. So please try to be calm and not worry! Let us know how you are, and I will too.

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  70. Anonymous12:54 PM

    Cannot tell you how much reading this blog has eased my mind. I got the call back as well. My second call back. Had one in 2006 as well. I'm scheduled for a mammogram and ultrasound next week. I'm trying to not freak out, I've been down this road before and heard those wonderful words from the tecnhician that "everything looks fine". Something is different this time in my right breast from last year. Last year it was the left breast that had the mammoagram and ultrasound. In 2006 it was the right breast.

    I think at some point, you have to get your head on straight or the roller coaster of emotions will kill you. I'm working on being positive. One step at a time, one decision at a time and not allowing myself to worry about the unknown. Right now it's a mammogram on Thursday, thats all that's on my calendar.

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  71. Anonymous7:07 PM

    I, too, received the dreaded call back.I'm 53, so it was my 13th mammogram(fitting). Never had an issue in the past with any previous ones. I was asked to come in the next morning for a repeat mammo and possibly an ultrasound. Needless to say...I didn't get much sleep that night! I was quite anxious, although I tried to reason with myself, if it was cancer it wasn't there a year earlier, so it had to be small and highly treatable. When I got there the tech showed me the suspicious area and explained what they were looking at and how this mammo would be different in the fact they were zeroing in on the new finding only. The repeat test itself took about 10 minutes. The radiologist came in to talk to me within five minutes. He told me everything looked great and we'll see you in a year. Those were such wonderful words. I know it's easier said than done, but if you do get the dreaded phone call...try to remain calm and take the attitude, "chances are it will be fine, and if it's not, take each step as it comes".

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  72. Thank you for the blog..I am 66 and got the call yesterday to come back in for my second mammogram. Having lost my husband last year I have been freaking out, thinking my family cannot take anymore bad news. Your blog has helped me so much, hearing from so many other woman who are going through the same thing,and having good results. Thank you to all the brave woman who have responded to your wonderful blog.

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  73. Denise5:40 PM

    I just got a call back for a second mammogram also. I wasn't given a reason just needed additional views on my right breast. I won't lie I am a little freaked out. I know they are usually nothing. I am also stressed over the cost of all this because our insurance won't pay anything until we pay the first $7000 out of our own pocket so that is an extra worry on top of things. I go in a little over a week and will pray for all of you going through the same thing

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  74. Anonymous11:45 PM

    I just got the call as well. I'm glad I found this post because I am really scared and I don't really have anyone to talk to. I am a single mom and the Dad isn't in the picture, and I just started University to try to improve on our financial situation. I'm 45 and my cousin died of breast cancer when she was 40, my Aunt lost a breast when she was 45. The woman I spoke to couldn't give me ANY information except to say that they want to do a longer, more digitally enhanced breast exam. All I can think about is my son right now. Since my appt is in a few weeks, I am hoping it isn't serious. Thanks for creating this. I really needed to tell someone how I felt and read about how others are coping.

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  75. Thanks so much for all the info. I am lying sleepless before my second mammogram for densities on both breasts. Knowing the procedure helps a lot. This is my first digital, so I am hoping that is part of the problem. Trying to keep calm and taking it a step at a time. Thanks for taking the time to write.

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  76. Peggy,
    I agree stay calm. I hope all goes well.

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  77. Tanya9:22 AM

    I had my mammogram last week and got a call back yesterday on it. They want to do an ultrasound on me today. My mind is racing. I hardly slept last night. I'm trying to be positive but it's hard. Your post really helped me to know others who have dealt with this before.

    I am really hoping that it's nothing serious and that everything is ok.

    Tanya

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  78. Tanya,
    Thinking of you while you wait. Try to relax. Hoping it ends up being nothing.

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  79. I had my breast ultrasound done yesterday. I find out the results for it at 1 pm today. I'm really hoping it doesn't need to go to biopsy. I've never been so worried before. I've lost 5 pounds this last week over the stress from it.

    Tanya

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  80. Tanya,
    What did you find out?

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  81. Going in for a 2nd mammogram tomorrow. First time I've had to do it. I'm 52, no family history. Just wonder if the tech will tell me anything or if I will have to wait all weekend. Do you know if the actual radiologist does 2nd mammograms or if it will just be another tech that will tell me they can't tell me anything? Thanks, KO

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  82. KO,
    I doubt if the technician will tell you anything. And yes you will most likely have to wait all weekend. The radiologist will not perform the 2nd mammogram. Sorry I know waiting sucks.

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  83. Anonymous7:29 AM

    Now its my turn..Going today for a call back because something changed from my last mam about 3 years ago. I had no insurance so haven't gone since then and now a call back. Very nervous since the Monday morning call but took the Wednesday morning appointment to know sooner than later if something is up but not sure how I feel about it. Here we go. Just two hours away from everything is fine or life is no longer what you thought it was...

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  84. smac197310:22 AM

    Headed for my return visit on Monday. Went yesterday for my first ever mammo (40 in April) and in January when I got the script the doc said - DO NOT PANIC, they will more than likely call you back to look again. They've never seen you before. I was OK most of yesterday and this AM she called. Said the radiologist wanted to see me again there was a dense area but she said it twice that they felt that it was just dense tissue and they just want to look. So .... I have family in starting tomorrow and I'm going to try to enjoy them and put this off and worry if I have to worry. My very dear friend cancelled all her morning appointments and will be coming with me so I'm not alone. Everything will work out for my highest good!!!! Thanks for this blog it's really calmed me tremendously!!!

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  85. I went for my yearly mammogram and the dr saw something so a second mammogram. Then the dr wanted to talk to me. That scared me. He showed me the cluster of white spots. They were not there my last mammogram. He suggested a biopsy. I asked if I could wait a few months and have another mammogram. I thought cancer was a lump. He was very serious and pointed to the cluster and said this is what cancer looks like in the beginning. His seriousness scared me.

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  86. Anonymous9:19 PM

    Like you ladies, I received the call for another look. I am uneasy and scared. Thank you for providing a forum to talk and gleen information. I go in on Thursday (it is Tuesday evening). Prayers are appreciated!

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  87. Anonymous2:59 PM

    Thank you for this blog, it was really helpful. Going in tomorrow for a follow-up mammo for the first time; they want a closer look at calcifications behind my left nipple. I've been OK all week leading up to this appt, and know it might be nothing, but am suddenly starting to freak out. This was only my second mammogram so I totally wasn't expecting anything out of the ordinary!

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  88. Anonymous,
    My call-back was on my second-mammogram too and not something I was expecting. Good luck to you. Sending positive vibes that it is just calcifications and all is fine.

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  89. Anonymous7:58 PM

    Hi all... I am so happy to have found this page.
    I just turned 45 & I have to admit that I haven't had a mammogram for about 7 years (right before I had my breast reduction)...We are about to move to a remote area and so I thought well, being its breast cancer awareness month... (thank goodness for being a football fan and seeing all the pink displayed)... I thought I should go in for a routine mammogram...I was "self-referred" and went in...they told me I would receive my letter with results in a few days.
    I received the letter on Friday afternoon:
    "return for spot compression on left breast - possible ultrasound. Please call immediately to schedule".
    I called right away, they gave me the first appointment for Monday morning (today)...right after the spot compression, I asked the tech what would determine the ultrasound...she had a blank look on her face and said I'll be right back...10 minutes later she returned again with the same look on her face stating the radiologist needs the ultrasound. She gave me a hug and had tears welling up and said everything is going to be okay.
    During the ultrasound, the other tech of course couldn't tell me anything. I asked to see the screen, she turned it away from me and said "no, I'm sorry."
    This was done at the hospital and my first time at this facility...seems to me that if they just needed to get a "baseline" they would have done spot compression on both breasts and ultrasound on both not just the left.
    I need to wait until I receive my next letter and I'm freaking out.
    I am at the brink of tears here and there.
    The big question I have is to myself "WHY DID I WAIT SO LONG TO HAVE A MAMMOGRAM DONE??!!" What if this is a serious issue? What have I ignored for so long?
    I have a tad bit of anxiety as it is. I am a worrier by nature.
    Has anyone had a "baseline" go like this?
    Any advice?
    Thanks in advance.
    CC

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  90. Anonymous5:00 PM

    You are so kind to respond to everyone with such support, Savvy Working Girl. I just received the dreaded call for 2nd mammogram today and after reading all this, I'm actually calm. This appears to happen all the time and if we can, we should try to treat the return as nothing more than the second step in what can be a 2-step process. Good luck everyone!

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  91. Lila Edwards9:20 AM

    So glad I came across your blog while researching on getting a "2nd Mammogram". I had my first one done 2 days ago (12/26/13), was called the next day and am now scheduled for my 2nd one on NYE. I am a bit "anxious", but after reading ALL (yes, every single one, haha)I am more at ease now. I have no family history of breast cancer, and realize that whatever was seen on my right breast could be anything. No time to panic, as I can't control anything & I will say that after a simple phone call requesting a 2nd one, life has even a better meaning for me! God bless each and every person who has posted and thank you!! I've done the Avon walk for Breast Cancer in 2008 & 2009 & believe I will be walking again this year in Chicago! Going to post an update to offer hope & support regardless of results! Much love, Lila in NW Indiana.

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  92. Lila and anonymous,
    I am happy to hear you have found some solace in reading all of the comments on this post. I sincerely hope your need for a 2nd mammo was just a fluke and everything is fine. Lila I would appreciate to learn your results. My fingers are crossed.

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  93. Hello all, I am going in tomorrow morning for a call back on a mammogram that I had done Saturday and I have to say that I am absolutely freaking OUT!! I have had a biopsy in the past and a call back also and EVERY TIME I am beside myself with fear. The lady that called said that there was some calcification and that I would need a 3D image and a possible sonogram. This blog has really helped but I cannot seem to stop my heart from racing or the tears from falling...Words of wisdom please!!

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  94. Tracey,
    The good news is that they are calling in a calcification. My co-worker's wife had to go in for a second mammo - which ended up being cancer. They knew prior to going in it was NOT a calcification. I don't work in the health profession, but do hope hearing that story will help you relax a bit.

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  95. Thanks for this really helpful information. It will help me should I ever have a calcification. Thanks for stopping by Psychowith6.

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  96. Anonymous12:53 PM

    Thank you so much for posting this. I have a biopsy coming up next week and am not only scared of a dx but of the pain of the procedure. I don't tolerate pain at all and have a very difficult time afterwards. Can anything be done to alleviate this pain before the procedure?????

    Thanks for any help.


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  97. The pain really isn't all that bad. You can check with your doctor, but they don't want you taking any aspirin products beforehand. Perhaps you could take a Tylenol, but I wouldn't.

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  98. Anonymous1:35 PM

    Went Saturday for mammo got call today, Tues, to come in for another mammo on right breast and ultrasound. Said should take about 2 hours and radiologist would give me the results immediately after. (2 hours?)(read right away?) Been having family all around me being diagnosed with breast and other cancer and I'm just a little tweaked. Had this happen many years ago before digital mammos and did the biopsy thing that came back negative. Going tomorrow ... one word ....YIKES (m)

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  99. Anonymous12:02 PM

    I had my annual mammo yesterday and had to have additional pics taken and an ultrasound...the dr came in and said the ultrasound looked ok but the mammo had showed a white speck that wasn't on the last mammo...she said I could wait six months and repeat a mammo or do an MRI...I haven't seen anyone mention having an MRI...is that a normal course of action? She didn't mention anything about having a biopsy. I am trying to find any reason to hope here so if the ultrasound didn't show anything, that is a good sign right? Scared here...

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  100. Anonymous4:27 PM

    UK person here. I'm so relieved and grateful to read this thread. I'm going back in next week as there is calcification in my left breast, which was not there last time. I was scared so I spoke to the radiologist on the phone today and they might do another mammogram, an ultrasound or a biopsy if needed (all on the same day) with results the same day if at all possible. I'm grateful for our National Health Service as it's all free. My heart goes out to anyone who has to worry about money at a time like this. I wish you all the best outcomes ladies. Tracey.

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  101. Anonymous9:16 PM

    I had my annual mammogram done on Friday afternoon. Monday afternoon I received a call from the breast center to come back for some more testing as they saw a difference in my left breast from my last mammogram. I tried to schedule it for 2 weeks from now because I am currently in the process of buying a house and next week have to be out of town all week, training new employees, and have so much going on right now that I felt I could focus on it better in two weeks. The lady scheduling the appointment asked if I had anything available this week. I told her not really. She told me they wanted me to come in this week if possible. So I said I could try to reschedule appointments on Thursday or Friday. She said they would see me Thursday then. Now, I'm worried that they called me to reschedule and would not even wait two weeks. I haven't even received my report in the mail yet. Hopefully, it's nothing but some calcification, but them insisting I come in this week and calling instead of waiting for the report to get to me with a recommendation of more testing ... Is it Thursday yet?

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  102. A mammogram done in the summer of 2013 found a cluster of microcalcifications in my right breast. I went for a second mammogram (within weeks, I think) to get it magnified. I was then told they appeared to be indeterminate in nature so I should have a sterotactic biopsy under compression (mammogram). This was scheduled in October 2013. They collected eight samples. It sounded like an air gun going off eight times, but it didn't hurt.
    The problem is, before the needle went in I was left in compression for a long time while the doctor went to see another patient who had an "urgent case and grabbed him in the hallway." They just left me there and old me not to breathe for several minutes. Some fight or flight kicked in and I threatened to leave if they did not release the pressure. That was psychologically rattling. Thankfully, they gave me an ice patch to take home, which really helped.
    Two weeks later I got the results - as negative - from a surgeon I was told to see. She said they only got two samples of calcifications out of the eight tissue samples, so she wanted to do a surgical biopsy. I declined and asked to get another mammogram in six months to see if there were any changes, also because I read that the majority of calcifications are found to be benign.
    After that mammogram, the spots were still there, and the surgeon repeated that she wanted to do the surgical (excisional) biopsy. She said I "refused a second stereotactic biopsy because of my terrible experience." I said, no, I was "uncomfortable" having my breast compressed for so long and that a second stereotactic biopsy was not presented as an option six months ago, only surgery. She argued it WAS offered as an option. Oh well. We remembered things differently. So I said ok to the surgery. She said it was the only way to get all the calcifications.
    I had the excisional biopsy in November 2014. On the form it actually referred to it as a lumpectomy, which I found strange. Well, I had to wait two and a half weeks for the results for that biopsy and it was negative. BUT the surgeon said she didn't think she got all the suspicious tissue because the guide wire that the radiologist inserted to help her get to the spot was bent. She then scheduled a follow-up mammogram to be done in three months.
    Well, today - three weeks after that mammogram - I had an appointment to find out what was on the images and she said the spots are still there, and that what happened during the surgery was pretty unusual, not being able to remove the suspicious tissue. She said she thinks she only got the margins of it. She said missing the spot only happens with one in 200 cases. She also said the spots were "progressing." I asked what did that mean and she said there appears to be more of them. She also said the two calcification samples taken in 2013 that were benign "did not match" what was on the images, meaning (I had to ask again what that means) the radiologist saw spots that were irregular or "abnormal" shape.
    Both of us said it's very frustrating that this has dragged on for so long. She has recommended yet another stereotactic biopsy and I agreed, but told her after that if it comes back negative I AM DONE with having any more procedures. She said the calcifications are in a difficult-to-reach spot near the chest wall and that has added to the difficulty in all these tests to completely rule out cancer or find it. I don't know when this latest biopsy will be scheduled. They will call. Needless to say I'm pretty anxious to know for sure if I'm in the clear once and for all – or if I have cancer. Hey everyone, pray for me. I feel so very alone right now.

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  103. Sorry, I just posted... I am 53 and went through menopause a couple of years ago. Sending good thoughts to all of you out there.

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  104. So glad you posted this. I just got the call that my mammongram came back "indeterminate". I am a freaking mess. Reading this did ease my mind a small amount. I just hope I can hold it together in front of my 11 year old daughter until I find out for sure what is going on. My worst fear is getting sick and dying and leaving her.

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  105. Anonymous5:23 PM

    Just got home from biopsy and anyone that has to go thru this it is not a terrible experience. Very minor discomfort that lasts seconds. I am a stomach sleeper so there was no discomfort in positioning. These calcifications are the size of a grain of salt. Caught early there will be no problem. My Doctor took 12 samples and felt good about them. Results within 24 hours. My entire staff was fabulous. Explaining and hand holding. I did take a Xanax before the test. My biggest ugh is not being in pool for 7-10 days and limited yoga and tennis...

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  106. Anonymous1:13 PM

    I wish I had been offered the option of a biopsy. When calcifications were seen on a regular mammogram I was sent for a diagnostic mammogram. I was then told that I needed a diagnostic mammogram every 6 months for 2 years to be sure everything was OK. My sister had breast cancer but thankfully she is OK after surgery and chemo. I worried about it for 2 years. About a week ago I had the last diagnostic test done and everything was OK. Major relief!

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