Breast Calcifications

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 on mammograms. They are extremely common and are usually associated with benign conditions. Calcifications can sometimes be a very early sign of breast cancer. For this reason radiologists carefully analyze all calcifications seen on a mammogram.
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How are calcifications evaluated?

Calcifications are usually evaluated with magnification (enlargement) views. These provide the radiologist with more information regarding size, shape and distribution of calcifications. They can then be categorized as benign, probably benign, indeterminate or suspicious.

"Benign" calcifications are of no concern and can simply be evaluated on subsequent routine mammograms. "Probably benign" calcifications are more than 98% likely to reflect a benign process. "Indeterminate" or "suspicious" calcifications may be seen in both benign and malignant disease. Most commonly these prove to be benign but biopsy is needed to establish this with certainty.

In our experience, only one of every four women with calcifications thought to be concerning enough to warrant biopsy, has had a breast cancer (usually at an early stage).


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What is a biopsy?

A biopsy is the removal of a small amount of tissue for analysis under a microscope. This will determine whether calcifications seen on a mammogram are associated with a benign (usual) or a malignant process.

Breast biopsies for calcifications can be performed in one of two ways.

Surgical biopsy:

This procedure is performed by a surgeon in the operating room under local or general anesthesia. It usually requires a preoperative localization procedure in which the radiologist, guided by the mammogram, places a needle into the calcifications and injects a blue dye to stain the tissue so the surgeon can remove all or part of the calcified area for microscopic examination. The localizing needle is either left in place or replaced by a thin wire, which the surgeon then uses to guide the placement of a skin incision and to direct the removal calcifications.

Stereotactic core needle biopsy:

In selected instances, depending upon the appearance and location of calcifications and upon breast size, small slivers of tissue containing the calcium deposits can be removed for microscopic analysis using a thin, hollow needle under computer guidance. This procedure is performed in the Breast Health Center by a radiologist using a special table and guidance device. It requires only minimal local anesthesia and, if successful, can provide a tissue diagnosis without the need for surgery.


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How are probably benign calcifications followed? Do they ever become malignant?

Calcifications associated with a benign process in the breast do not undergo malignant change. Those calcifications which are proven to be associated with malignancy are thought to be malignant from the time of their initial appearance. When calcifications are assigned to a "probably benign" category the risk of malignancy is considered to be less than 2% and close surveillance is usually recommended. This takes the form of a follow-up mammogram in six months. If no change is detected and the patient is over age 40, a further follow-up mammogram including a routine examination of the opposite breast is recommended in an additional six months. After a full year of follow-up if no change is observed, only routine annual examinations are recommended thereafter. Magnification views are usually obtained at each follow-up visit. This allows the most accurate assessment of any change in the size, number or shape of calcifications.

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Does diet play a role in developing breast calcifications?

This is a common question and concern of patients whose mammograms demonstrate calcifications. There is no known association between dietary calcium intake or any other dietary factors and the development of breast calcifications. There is, likewise, no correlation between post-menopausal hormone replacement therapy and breast calcifications.

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See additional Breast Care and Women's Health

Services at California Pacific Medical Center

Breast Cancer Recovery Program
Breast Health Center
Lady's Touch

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