Irregular Breast Calcifications: Surgery vs. Monitoring

Irregular breast calcifications

Hello, I would like to ask if I have already undergone a stereotactic core needle biopsy (after having X-rays and MRI scans), and the doctor mentioned that it appears to be benign.
However, due to the large and irregular area of calcification, they suggested obtaining samples from other calcified areas to determine if they are also benign (surgery).
Now, my questions are: 1.
Is surgery necessary, or is regular monitoring a better option (I'm concerned about breast deformity)? 2.
If surgery is performed, will it be under general anesthesia, and should the entire calcified area be removed (to avoid a second surgery)? 3.
If the entire calcified area is removed, will there be significant breast deformity? Will I need to undergo reconstructive surgery? Thank you for your help.

Hao Nan Ren, 30~39 year old female. Ask Date: 2017/07/25

Dr. Yu Mingchang reply Surgery

Hello; is this you? Please take a moment to check the breast surgical health services that the Ministry of Health and Welfare is concerned about for you.

Reply Date: 2017/07/25

More Info

Understanding the management of irregular breast calcifications can be quite complex, especially when considering the implications of surgery versus monitoring. Based on your situation, where you have already undergone stereotactic core needle biopsy and imaging studies (X-ray and MRI), and the initial findings suggest benignity, yet there are concerns about the irregular and extensive nature of the calcifications, let's break down your questions.

1. Surgery vs. Monitoring: The decision to proceed with surgery or to adopt a watchful waiting approach largely depends on the characteristics of the calcifications and the overall clinical picture. If the calcifications are extensive and irregular, even if the initial biopsy suggests they are benign, there is a possibility that they could harbor atypical or malignant changes that were not captured in the biopsy. In such cases, surgical excision may be recommended to ensure that any potentially concerning areas are adequately addressed. However, if the majority of the calcifications are confirmed benign and there are no other risk factors present, regular monitoring with follow-up imaging (such as mammograms or ultrasounds) may be an acceptable approach. The key is to have a thorough discussion with your healthcare provider about the risks and benefits of each option.

2. Extent of Surgery: If surgery is deemed necessary, it is often advisable to remove the entire area of concern, especially if the calcifications are extensive. This approach minimizes the risk of needing additional surgeries in the future and provides peace of mind regarding the pathology of the excised tissue. The decision on whether to perform a lumpectomy (removing only the affected area) or a more extensive procedure will depend on the size and location of the calcifications, as well as your breast size and shape.

3. Impact on Breast Appearance: The concern about breast shape and potential deformity after surgery is valid. The extent of change in breast appearance will depend on the size of the excised tissue and your individual anatomy. In many cases, a lumpectomy can be performed with minimal impact on breast shape, especially if the excised area is small relative to the overall breast size. However, if a larger area is removed, there may be noticeable changes. In such cases, breast reconstruction or cosmetic surgery can be considered to restore the breast's appearance. It's essential to discuss these concerns with your surgeon, who can provide insights based on your specific situation and may refer you to a plastic surgeon if needed.

In conclusion, the management of irregular breast calcifications is a nuanced decision that should be made collaboratively with your healthcare team. It is crucial to weigh the risks of potential malignancy against the benefits of surgery and the implications for your breast appearance. Regular follow-up and open communication with your medical team will help ensure that you make the best decision for your health and peace of mind. Remember, early detection and intervention are key in breast health, and addressing any concerns proactively is always a wise approach.

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