Learn about breast calcifications and micro-calcifications, deposits of calcium in the breast tissue.
What are breast calcifications?
Calcifications are calcium deposits found within breast tissue. These deposits are seen as white spots on mammograms. They are extremely common and are usually benign. In a few cases, calcifications can sometimes be a very early sign of breast cancer. For this reason, radiologists carefully evaluate all calcifications they see on a mammogram.
How are calcifications evaluated?
Calcifications are usually evaluated with X-ray magnification views. With these magnified X-rays, the radiologist can better tell the size, shape and number of calcifications. Using this information, the radiologist categorizes the calcifications as:
- Probably benign
Benign calcifications are of no medical concern and will be evaluated on future mammograms by comparing images from year to year.
Probably benign calcifications are more than 98% likely to be benign.
Suspicious calcifications may be seen in either benign or malignant (cancerous) situations. In our experience, only one out of every four to five patients with suspicious calcifications has a breast cancer and those are usually at a very early stage.
What is a biopsy?
A biopsy is the removal of a small amount of tissue for laboratory analysis. Biopsies are done to determine whether the calcifications seen on a mammogram are benign or malignant.
Breast biopsies for calcifications can be performed in one of two ways.
- Surgical biopsy: A surgeon takes a sample of breast tissue containing calcifications in the hospital operating room under local or general anesthesia. First, a localization procedure is usually done by the radiologist to mark the area of calcifications for the operating surgeon. The radiologist places a needle into the area of calcifications and then injects blue dye to mark the tissue. The needle or a very thin wire is left in place by the radiologist to mark the area of calcifications. The tissue is then removed by the surgeon and sent to the laboratory for examination.
- Stereotactic core needle biopsy: For some patients, depending upon the location of the calcifications, their appearance, and the size of the breast, the radiologist can remove 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 and the tissue can be sent to the laboratory for analysis without surgery.
- Needle Localization Breast Biopsy
- Ultrasound-Guided Core Breast Biopsy
- Stereotactic Breast Biopsy
- After a Needle Biopsy
How are probably benign calcifications followed? Do they ever become malignant?
"Benign" calcifications in the breast do not become malignant. Malignant calcifications are malignant from the time they first appear. When the radiologist assigns calcifications to a "probably benign" category, the risk of malignancy is considered to be less than 2%. Close monitoring is recommended and includes:
- Follow-up diagnostic mammogram in six months.
- If no changes are seen at the six month follow-up and the patient is over age 40, a diagnostic mammogram and a routine examination of the opposite breast is recommended in another six months.
- After a full year of follow-up in which no changes are seen, patients are then monitored by having mammograms once a year.
- Magnification views are usually taken at each follow-up visit to accurately determine any change in the size, shape or number of calcifications.
Does diet or hormone replacement therapy (HRT) play a role in developing breast calcifications?
There is no known link between calcium intake in diet and the formation of breast calcifications. Also, no correlation has been found between post-menopausal hormone replacement therapy and the development of breast calcifications.