By Dr. Kathleen Ruddy
Microcalcifications are tiny calcium deposits about the size of a grain of salt that occasionally form in the breast. Because of their diminutive size, they never cause visible lumps. They never ache or cause pain of any kind, and they cannot be felt from the outside during a very thorough and careful self-exam or even during a physical examination performed by an experienced physician. The fact that microcalcifications are so common, yet so impossible to detect by sight or touch, is one of the best reasons never to skip an annual mammogram. Read on to learn about the causes, risks, and treatment of malignant microcalcifications.
Causes of Microcalcifications
The majority of microcalcifications are benign. Benign microcalcifications occur as a result of any number of things from cell secretions to mastitis, which is an infection in the milk ducts. These calcifications are no cause for concern, and don’t require any further testing or treatment.
Malignant Microcalcifications
A small percentage of microcalcifications, however, do require a more thorough examination. These microcalcifications appear on a mammogram in very tight clusters, and they are polymorphic, that is, they are markedly different in size and shape when compared to other deposits that exist in the breast. If clustered polymorphic microcalcifications appear on your mammogram, you will be sent for another mammogram, this time with magnification. An ultrasound may be ordered as well. If the more detailed mammogram and ultrasound images do not allay your doctor’s suspicions, then he will talk to you about doing a biopsy of the microcalcifications in your breast.
EDITOR’S TIP:
Even though ductal carcinoma in situ is stage 0, that does not lessen the anxiety of having to go through treatment for it. To help deal with the stress of undergoing radiation treatment, you can employ some alternative therapies such as massage, music therapy, yoga, and meditation.
Diagnosis of Malignant Microcalcifications
If your doctor advises you to have a biopsy, and that biopsy reveals one or more areas of malignancy in your microcalcifications, then your diagnosis is ductal carcinoma in situ (DCIS). In the case of DCIS, the diseased cells are limited to the milk ducts, and have not invaded any of the surrounding tissue. This type of cancer is classified as stage 0 because it is non-invasive, which means that it is not life threatening. However, treatment is required in order to keep the diseased cells from eventually invading the tissue surrounding the milk ducts. If this cancer goes untreated, and is allowed to spread even by a tiny margin beyond the milk ducts, it becomes an invasive cancer, and invasive cancer is life threatening.
DCIS Treatment Options
The treatment of DCIS is surgical. Immediately following diagnosis, you will be presented with two options. The first surgery that you could elect to have is a lumpectomy. During a lumpectomy, the diseased microcalcification is removed from your breast. The surgeon will remove it with a small margin of healthy tissue surrounding it, but it will not be so much tissue that an additional cosmetic or reconstructive procedure will be necessary. In order to achieve a cure as well as to protect against the remote possibility of recurrence, a lumpectomy should be followed by a course of radiation treatments. The second surgical option is a mastectomy, but because a simple lumpectomy followed by a course of radiation is such an effective cure for DCIS, removing the entire breast is unnecessary, except under certain very specific circumstances. You should consider a mastectomy if you have a very large cluster of diseased cells that is more than half the size or your entire breast, if you are not a candidate for radiation due to pregnancy or a chronic health condition, or if diseased cells were found near the margins of the tissue sample that was used for your biopsy.
Coping with a DCIS Diagnosis
Reach out and ask your doctor for more information, take advantage of the resources that he provides you with to learn everything that you can about DCIS, so you can go into your surgery feeling confident. When the time for your radiation treatments draws near, visit the hospital where you’ll be treated and inquire about a cancer patient education center, or something similar to The Patient Education Office at MD Anderson Cancer Center. More and more of the major hospitals and cancer centers have offices dedicated to educating patients, and there you’ll find a schedule of free classes and seminars on what to expect as you start radiation and how to manage the side effects. The classes and seminars are taught and given by nurses who are currently working on the oncology floors of these hospitals. The information and advice they have to offer is based on their first-hand experience, which makes it infinitely more valuable than anything you could read in a pamphlet.
Mammograms are normally employed only when you are old enough for regular annual screenings or after a lump of some sort has been felt during a breast examination. However, in the case of malignant microcalcifications, they cannot be felt under skin until after they become invasive, and at that point, it is much more serious. As such, they are rarely identified until after you begin regular mammograms at the age of 40, but if you have a family history or known increased risk factors for breast cancer, your doctor may wish to start regular screening at an earlier age. To increase your chance of catching malignant microcalcifications before they have become invasive, talk to your doctor about your family history and health to determine the best time to start regular mammograms.
If you’d like to receive more information about breast cancer and find out what the Breast Health and Healing Foundation is doing to battle the disease, please sign up for our newsletter. You can sign up here: http://breasthealthandhealing.org/im-in/.