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Dr. Andrew Rynne

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Got hurt in shoulder. Had breast cancer and having calcification. Why suggested for the second x-ray?

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Practicing since : 2007
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Yesterday I had an xray on my right shoulder after having hurt myself in the ocean waves. They have asked me to come back for a second xray - I had breast cancer in November, 2006, and have been healthy since my treatment of 2 lumpectomies and radiation, but I am aware that they have been monitoring calcification in my right breast, and I have had 2 mammograms this year to that effect (July 2012 and Nov 2012). My GP is away so the locum was unclear about what they saw yesterday (couldn't tell me whether it was in my breast or lung), and the new xray form notes '? linear calcification R lung field. I assume that this is simply the right breast calcification that they are monitoring, but am concerned. Please advise. Thank you.
Tue, 22 Jan 2013 in Bones, Muscles and Joints
Answered by Dr. Ganesh Sanap 23 minutes later

Thanks for writing in.

You are correct with respect to calcification. Based on the information provided, to me, these may be linear calcification due to post radiotherapy changes.

Injury to shoulder with calcification may be due avulsion injury or fracture. However these two conditions are extremely painful and are not easy to miss on X-ray. Therefore there is no need to worry.

It will be better if you talk with your locum physician about previous treatment and x-rays. Your previous mammogram can be used for comparison. If calcification is newer one then further investigation will be necessary depending on clinical profile and examination.

Hope I have answered your query. Any further doubts are welcome.

Above answer was peer-reviewed by
Follow-up: Got hurt in shoulder. Had breast cancer and having calcification. Why suggested for the second x-ray? 23 hours later
Thank you for the prompt reply.
I received further information from the radiologist yesterday. She showed me a round shadow (13mm across) just below the clavicle, where several bones XXXXXXX She was concerned that this could be a mass in the lung. Given my past history of breast cancer, she thought that it could have been a metastasis. I explained to her that my breast cancer was caught early (Stage I, Grade I, negative for the BRCA gene, and negative for lymph node involvement), and she agreed that this would make it very unlikely that the breast cancer had spread to the lung.
She has ordered a CT scan to examine the density of the cells where the shadow was observed.
I am trying not to worry, but I'm unclear on what the shadow could be, if it isn't a tumor. Could it be a bruise or broken blood vessel, due to my recent shoulder injury? Do shadows occur that aren't related to cancer? The radiotherapy I received was on the left side, and the shadow is on my right side, so it shouldn't be caused to that.
Thanks again.
Answered by Dr. Ganesh Sanap 1 hour later
Hi, welcome back.

Broken vessel will cause severe hemorrhage which can be life threatening. Also bruise will not calcify in such a short duration. So it is not due to broken vessel or bruise.

One thing is that calcification suggests a chronic process, which is most commonly seen in benign changes. So we can hope for benign lesions like calcified granuloma or hamartoma.

However in view of your history there is no other way to diagnose it except doing a CT scan. Radiotherapy changes can occur bilaterally. You go for a CT scan without hesitation. It is less likely due to breast cancer as it was diagnosed at a very early stage.

Hope you have got answer for your doubts.

Thanking you.
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