What Is Breast Calcifications

Breast calcifications are small spots of calcium, found by chance in the tissue of a woman’s breast. These are often not a sign of concern and should not worry you. However, at times, these may suggest the presence of cancerous changes in the tissue. Many women come across these spots, known as breast calcifications, during routine mammograms or diagnostic tests. Breast calcifications, which are calcium deposits in the breast tissue, are very typical, especially in women over 50. While they may raise questions and cause some apprehension, it's important to understand that these are often not a cause for alarm. In fact, the majority of calcifications are benign and do not pose a threat to your health.

This informative article aims to provide you with valuable insights into their types, causes, signs and symptoms, as well as management and treatment options. Read on to gain a comprehensive understanding of breast calcifications and how they can be effectively managed and treated.

Overview

Breast calcifications are tiny deposits of calcium that can appear as white spots or specks on a mammogram. They are categorized into two main types: macrocalcifications and microcalcifications. Macrocalcifications (less than 0.5 mm) are larger, irregularly shaped deposits that are usually benign, while microcalcifications are smaller and can be categorized as benign, indeterminate, or suspicious for malignancy.¹

Types of breast calcifications

Macrocalcifications: These are coarse, larger calcium deposits that are often noncancerous and typically related to ageing or non-proliferative benign breast conditions.

Microcalcifications

• Benign Microcalcifications: These tiny deposits are usually round or oval and are frequently associated with benign breast conditions, such as fibrocystic changes
• Indeterminate Microcalcifications: These calcifications exhibit characteristics that make it difficult to determine their nature, requiring further evaluation
• Suspicious Microcalcifications: These microcalcifications have features that raise concern for malignancy and warrant additional diagnostic tests^2,5

Causes of breast calcifications

The exact cause of breast calcifications is not fully understood. However, some factors may contribute to the formation of benign calcifications:

• Arterial ageing
• Injury to breast tissue, such as that caused by a vehicle accident or past breast cancer treatments, such as surgery or radiation therapy 
• Infection in the breast tissues (called mastitis)
• Calcium deposits in the skin or blood vessels, cysts, or non-cancerous growths in the breast such as fibroadenomas 
• Fat necrosis⁵

Signs and symptoms of breast calcifications

Breast calcifications themselves typically do not cause any specific signs or symptoms that can be felt or observed. They are often discovered incidentally during routine mammograms or diagnostic imaging tests. However, in some cases, underlying conditions associated with breast calcifications may manifest with certain signs and symptoms. Here are some signs and symptoms that may be observed:

• Breast Pain
• Breast Lumpiness
• Nipple Discharge
• Changes in Breast Size or Shape³

Management and treatment for breast calcifications

The management of breast calcifications depends on their type, characteristics, and the presence of associated risk factors. The following are the general approaches to the management and treatment of breast calcifications:

Benign bacrocalcifications

Benign macrocalcifications usually do not require any specific treatment or follow-up. They are typically considered noncancerous and are often related to ageing or benign breast conditions. Your healthcare provider may recommend regular follow-up mammograms to monitor any changes in the calcifications over time.⁴

Indeterminate or suspicious Microcalcifications

If microcalcifications are categorized as indeterminate or suspicious for malignancy, further evaluation is necessary to determine their nature. This may involve additional imaging tests and procedures, such as:

• Diagnostic Mammogram: A diagnostic mammogram is a specialized mammogram that provides more detailed images of the breast tissue. It helps to assess the characteristics of the calcifications and determine if any further action is required
• Breast Ultrasound: A breast ultrasound may be performed to obtain additional information about the calcifications. It uses sound waves to create images of breast tissue and can help differentiate between benign and malignant calcifications
• Breast Biopsy: A breast biopsy is the definitive diagnostic procedure for determining the nature of calcifications. There are different types of breast biopsies, including:
  • Fine-needle aspiration biopsy: A thin needle is used to extract a sample of cells from the calcifications for examination under a microscope
  • Core needle biopsy: A larger needle is used to remove a small cylinder of tissue containing the calcifications
  • Surgical biopsy: In some cases, a surgical procedure may be necessary to remove a larger sample of tissue for analysis

The biopsy sample is then examined by a pathologist to determine if the calcifications are benign or indicative of malignancy.

• Follow-up and treatment: The management and treatment following an indeterminate or suspicious finding will depend on the biopsy results. If the calcifications are determined to be benign, regular surveillance with mammograms may be recommended. However, if they are found to be malignant, further treatment options, such as surgery, radiation therapy, or chemotherapy, may be recommended by your healthcare provider^6,7

Diagnosis

The diagnosis of breast calcifications involves various steps and imaging techniques. The following are the key components of the diagnostic process:

• Mammography: Mammography is the primary screening tool for detecting breast calcifications. It uses low-dose X-rays to create detailed images of the breast tissue. If calcifications are detected on a mammogram, further evaluation may be recommended
• Additional Imaging: In some cases, additional imaging tests may be performed to gather more information about the calcifications. These may include breast ultrasound or magnetic resonance imaging (MRI). These imaging modalities can provide a more detailed view of the breast tissue and help characterize the calcifications
• Breast Biopsy: If the calcifications appear suspicious or indeterminate on imaging, a breast biopsy may be performed to obtain a tissue sample for analysis. As mentioned earlier, different types of biopsies may be used, depending on the specific circumstances and the location of the calcifications
• Pathology Analysis: The tissue sample obtained from the biopsy is sent to a pathologist who examines it under a microscope. The pathologist analyses the cells and determines whether the calcifications are benign or indicative of malignancy^4,7

FAQs

How can I prevent breast calcifications?

Breast calcifications cannot be prevented, as their exact cause is unknown. However, maintaining a healthy lifestyle, including regular exercise and a balanced diet, may contribute to overall breast health.

How common are breast calcifications?

Breast calcifications are relatively common and are found in approximately 50% of women over the age of 50. They are more frequently observed in postmenopausal women.

Can breast calcifications turn into cancer?

Most breast calcifications are benign and do not lead to cancer. However, certain suspicious microcalcifications may be associated with early breast cancer. Further evaluation is necessary to determine their nature and appropriate management.

Who are at risk of breast calcifications

Breast calcifications can occur in women of any age, but they are more commonly found in postmenopausal women. Factors such as breast cancer diagnosis in the past, family history of breast and other cancers, changes in the BRCA gene, heavy breasts, a few genetic disorders, radiation exposure that is ionising, replacement of hormones, OTC contraceptives, and alcohol consumption may increase the risk.³

When should I see a doctor?

It is important to follow the recommendations of your healthcare provider regarding routine breast cancer screening, including mammograms. If breast calcifications are detected on a mammogram, your doctor will guide you on the appropriate steps for further evaluation and management.

Summary

Breast calcifications are small spots of calcium found in breast tissue that are often discovered during mammograms. While most calcifications are benign and not a cause for concern, certain types may indicate underlying conditions, including early breast cancer. Management depends on the type of calcifications, with benign macrocalcifications typically requiring no specific treatment, while indeterminate or suspicious microcalcifications may necessitate further evaluation through diagnostic mammograms, ultrasound, or biopsies.

The diagnosis involves mammography as the primary screening tool, followed by additional imaging and if needed, a biopsy for tissue analysis by a pathologist. Regular breast cancer screening and medical consultations are crucial for early detection and appropriate management of breast calcifications.