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Articles on Breast Health


What Are Breast Calcifications?

Calcification is a common process where small spots of calcium spots deposit themselves in breast tissue. These deposits can be the result of aging or other breast conditions such as fibroadenomas or cysts. Inflammation or foreign bodies such as implants or stitches can also lead to calcification. Calcium phosphate crystals tend to aggregate into clumps.

These small calcium deposits in the breast tissue that can be seen only on a mammogram. These calcium deposits are tiny and therefore cannot be felt by you or your doctor during a breast exam. Breast calcifications are common. Many women have at least one calcification that can be seen on a mammogram. Most breast calcifications aren’t associated with cancer. But certain patterns of calcifications, such as tight clusters with irregular shapes, can be associated with cancer.

What causes Breast Calcifications?

Calcium deposits can occur in the breast as a result of swelling, injury, aging blood vessels, a duct plugged with milk years before or cancer. Taking calcium pills does not cause them.

There are two types of calcifications

1.

Microcalcifications (smaller calcium deposits). These calcium deposits appear as very fine white specks on a mammogram. A radiologist carefully studies the shape and size of the calcium deposits to determine if they require further study. Most often, microcalcifications have nothing to do with cancer. A cluster is an area where there is a proliferation of many microcalcifications. Such clusters may be cancerous and are of most concern.


2.

Macrocalcifications: These are coarse calcium deposits and are usually representative of degeneration of the breasts, either due to inflammation, injuries or aging of the breast arteries. Such calcifications are generally benign and are usually found in women over the age of 50. On a mammogram, these calcium deposits appear as single white dots that are larger than microcalicifications. They are usually benign (not cancer).

 

Noncancerous (benign) causes of breast calcifications include:

  • Calcium within the fluid of noncancerous cyst (milke of calcium)

  • Calcification associated with a dilated milk duct

  • Previous injury to the breast (post-traumatic fat necrosis calcification)

  • Inflammation due to infection (mastitis)

  • Skin (dermal) calcifications cause dermatitis or residue from metallic partiles in powders, ointments and deodorants

  • Radiation therapy for breast cancer

  • Calcification of the arteries (vascular calcifications)

  • Calcifications in a fibroadenoma, a noncancerous growth

Use of Mammograms

Calcium deposits are tiny and cannot be felt by you or your doctor. A mammogram is used to detect calcifications. A mammogram can pick up microscopic deposits of calcium within breast tissue or even tiny blood vessels. The radiologist examines the shape, size and pattern of the calcifications to make a diagnosis.

Suspicious mammograms may be followed by core needle biopsy, as it is minimally traumatic and relatively less expensive than surgical biopsy. Sometimes, a biopsy is required to confirm the diagnosis. Since a mammogram reveals just an area of abnormal tissue, a stereotactic biopsy is used to locate the area to be biopsied. X rays are used to guide the radiologist. With a surgical biopsy the surgeon uses a scalpel to remove a chunk of tissue. Core biopsy involves insertion of a large needle through the skin. This is usually aided by computers. But some types of conditions necessitate surgical biopsy, such as when the lesion is next to the chest wall.

Follow-up

Once calcifications have been confirmed as harmless, your specialist may follow up with a repeat mammogram after 12 months.

A Quote From John R. Lee, M.D.

“Over the years I have seen my share of microcalcifications in breasts and, by using progesterone, in none of the patients did the condition progress to real cancer."


Sources

Sickles EA: Breast calcifications: mammographic evaluation. Radiology 1986 Aug; 160(2): 289-93

Whitman GJ, Stephens TW, Hopkins K: Benign and malignant breast calcifications. Contemporary Diagnostic Radiology 2002; 25: 1-6.