Breast calcifications can be cancerous

Mammography is frequently used to detect breast calcifications, particularly in women over the age of 50. They are typically gentle. They are classified as macrocalcifications and microcalcifications, with the latter usually indicating breast cancer or precancerous changes.

Calcifications in the breasts are mineral deposits of calcium that can be seen in mammography. They may or may not indicate cancer, but clusters of irregular and variously shaped microcalcifications are particularly suspicious. 

Mammography is the basic examination in the diagnosis of microcalcifications, but only a biopsy can give certainty. Calcifications do not usually cause breast pain.

Breast calcifications types

Calcifications are classified into several types. Microcalcifications are small calcifications in the breasts, while macrocalcifications are large calcifications. Breast calcifications can be either benign or malignant in nature.

Macrocalcifications in the breasts

On a mammogram, macrocalcifications appear as large white dots or dashes. They affect half of all women over the age of 50. They are almost always harmless. They are larger than microcalcifications and, as a result, can be seen on a breast ultrasound. Only mammography can reveal the smaller ones. If they are discovered, the doctor decides whether to proceed with further diagnosis or to observe the calcifications.

Microcalcifications in the breasts

Breast microcalcifications are more concerning than macrocalcifications. They resemble tiny white dots. They could be signs of a cancerous or precancerous condition. There are many different kinds of them, each with its own location and shape. There may be both benign and malignant changes among them.

Mild microcalcifications

They are most often visible in a mammogram as highly saturated, punctate shadows scattered throughout the breast or located in the walls of blood vessels. It is important to note that the vast majority of microcalcifications detected during mammography are benign.

Malignant microcalcifications

Microcalcifications are the first sign of breast cancer, formed in cancer cells even before the formation of a tumor. If found, a mammography-guided biopsy is ordered to assess the changes and confirm or exclude them. A marker made of titanium is placed in the place of the collected tissues and an operation is performed to remove the affected tissues.

Breast calcifications – interpretation of research

The BI-RADS classification is used to assess the changes revealed in the mammographic examination. The results are given on a scale of 0 to 6: 

  • Grade 0: Indicates an incomplete assessment and additional imaging studies are required. The risk of malignancy is uncertain and difficult to quantify.
  • Grade 1:  This is the norm, i.e. a completely normal picture. The risk of malignancy is 0%. No additional tests are necessary.
  • Grade 2:  The result is a mild lesion. The risk of malignancy is 0%. No additional tests are necessary.
  • Grade 3:  Indicates a lesion that is most likely benign. The risk of malignancy is estimated at ≤ 2%, but follow-up after six months and additional ultrasound examination are necessary.
  • Grade 4:  Suspicious lesion, risk of malignancy from 2 to 95%. Within this assessment, 3 more subgroups are distinguished:
    – 4a – a suspicious lesion, but with a low degree of malignancy probability,
    – 4b – a suspicious lesion with an average degree of malignancy probability,
    – 4c – a suspicious lesion with a high degree of malignancy probability, without visible signs of malignancy. Further diagnostics are needed to rule out or confirm malignancy.
  • Grade 5:  Lesion with a high probability (≥ 95%) of malignancy. Further diagnosis and treatment is needed.
  • Stage 6:  Indicates confirmed cancer – previously confirmed by other tests.

Only a specialist doctor can assess the nature of microcalcifications. Therefore, it is best to leave the interpretation of the research results to him.



4th Professional Medical Student. Karachi Medical and Dental College.

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