Technique For Finding Calcifications
The radiologist first makes sure the mammograms are of high quality, which is essential to detect and analyze breast calcifications. Then, the radiologist looks at each standard film using a standard search pattern so that no part of the film is unseen. Some radiologists use a search pattern of parallel lines over the films, like someone mowing a lawn, as described by Dr. Roger J. Jackman, to make sure all parts of the film are covered. With screen-film mammography , the radiologist uses a bright light to illuminate the darker portions of the film so the calcifications are easier to see. On digital mammography, the radiologist adjusts the windows and levels on the mammography workstation to optimize image contrast and brightness to find calcifications more easily.
After viewing the mammograms at standard magnification, the radiologist then uses a hand-held magnifying lens to examine each film this enlarges the mammogram image and makes the calcifications easier to detect. For digital mammography, the radiologist magnifies the mammogram electronically to make calcifications bigger and easier to see. Digital mammogram-viewing protocols usually incorporate electronic magnification of each image as part of the viewing workflow.
Lawrence W. Bassett, … Christopher P. Hsu, in, 2009
Are Most Microcalcifications Benign
Microcalcifications are small and may appear in clusters. They are usually benign , but can be a sign of breast cancer. Your doctor will note if they have changed over time and follow-up tests may be needed to rule out cancer. Photo A: Macrocalcifications are large and randomly spread throughout the breast.
Risk Factors And Symptoms
Risk Factors for Breast Calcifications
Aging is the main risk factor for breast calcifications. Breast calcifications are found in 50% of women over 50. They are found in only about 10% of women under the age of 50.
The following circumstances may make you more likely to have breast calcifications:
- An old injury to the breast
- Inflammation due to infection
- Prior radiation therapy for breast cancer
Symptoms of Breast Calcifications
Calcifications have no symptoms that a woman will notice herself . They are found during breast exams, such as a screening mammogram.
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What Is The Connection Between Microcalcifications And Breast Cancer
Microcalcifications and breast cancer can sometimes occur together. Microcalcifications, or microscopic bits of calcium, tend to build up in the area where cancer cells are quickly dividing and forming tumors. Microcalcifications are often detectable on mammograms, and doctors often consider them a sign of early breast cancer, or an indication of pre-cancerous activity in the breast tissue. While microcalcifications do not always signal breast cancer, the relationship that can exist between microcalcifications and developing tumors lets doctors know to investigate further for signs of cancer when microcalcifications appear.
Many women are diagnosed with early stage breast cancer after microcalcifications are found on mammogram results. Microcalcifications and breast cancer don’t always go hand in hand. Sometimes the microcalcifications appear in conjunction with benign tumor growth. But spotting the accumulation of calcium within breast tissue can help doctors detect breast cancer in its earliest stages, when treatment can be most effective and the patient’s chances of survival are highest.
What Are The Different Types Of Breast Calcifications
The two types of breast calcifications are microcalcifications and macrocalcifications.
Microcalcifications: These tiny calcifications are the more concerning of the two types because they could be cancerous. If a doctor sees these on a mammogram, additional testing may be needed.
Macrocalcifications: In contrast, macrocalcifications are larger and coarser areas of calcium deposits. Common in women older than 50, these may be caused by a variety of factors, including:
- Aging arteries
- Calcium deposits that originated elsewhere, like on the skin or blood vessels
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Types Of Breast Calcifications
Breast calcifications are of two types- macro-calcifications and micro-calcifications. Macrocalcifications appear as large white round shaped deposits of calcium on mammograms. They are very common in women above 50 years of age. They are usually benign, thus they do not require further probing.
Microcalcifications, on the other hand, can be a cause for concern. Micro-calcifications appear as tiny white specks on mammograms. In 80% of the cases, they turn out to be benign. However, if they are of certain shape and size, and appear in particular patterns, they need to be probed further.
Microcalcifications and Breast Cancer
Most of thebreast cancers start out as micro-calcifications. Out of all the breast cancers, majority of the ductal carcinoma in situ cases start out as micro-calcifications. However, some cases of breast cancers are also related to macro-calcifications. The question that arises is how are radiologists able to distinguish between calcifications that are benign from the ones that are malignant or has the potential to turn malignant in the future.
Upon examination of mammograms, radiologists classify calcifications as benign, indeterminate, and malignant. In order to classify calcifications as benign, indeterminate, and malignant, the radiologist will first carefully look at the morphology, size, distribution, variability, number, and stability of the calcifications. They will also look at previous years mammograms to reach a final verdict.
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Of course, any time you hear that something is different on your mammogram results, you become concerned. But if youre told that breast calcifications were detected, theres important information for you to know, starting with the fact that breast calcifications are exceedingly common.
We see breast calcifications all the time. Most of the time they are harmless and arent cause for concern, says Thomas Heck, MD, surgical director, the breast center at Miami Valley Hospital North.
Feeling more relaxed? Good! Lets learn more.
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Calcifications In Breast Cancer
While the presence of calcifications on a mammogram can sometimes alert healthcare providers to breast cancers that would otherwise go undetected, experts are learning that breast calcifications also may provide information about the prognosis of breast cancer.
According to a 2018 study, breast cancers that have microcalcifications are more likely to be HER2-positive, tend to have a higher tumor grade, are more likely to have spread to lymph nodes, and have a greater risk of recurrence. This information may be helpful for women with early-stage breast cancers who are weighing the benefits of treatments such as chemotherapy after surgery.
Are There Different Types Of Breast Calcifications
There are two types of breast calcification.
- Macrocalcifications: These appear as round and large bright white spots on a mammogram randomly scattered throughout the breast tissue. This is the most common type. They are typically not related to cancer and usually do not need follow up.
- Microcalcifications: These are smaller white spots on a mammogram. While these can be randomly scattered as well, they are sometimes grouped together and can be a sign of cancer. If your mammogram finds microcalcifications, your doctor will note any change in their appearance over time and probably order more tests.
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Should I Worry About Breast Calcifications
Medically Reviewed By: Tari A. King, MD, FACS
Receiving the news that something abnormal has turned up on a routine mammogram can be frightening, but breast calcifications are usually harmless. In rare instances, they can be an early sign of breast cancer, though calcifications themselves do not develop into cancer.
What Is The Relationship Between Breast Calcifications And Cancer
As breast tissue ages and changes naturally, calcifications can be a normal byproduct of those changing cells. They cannot develop into cancer rather, calcifications can be an indicator of some underlying process that involves the cancerous cells.
During a mammogram, calcifications appear as small white dots in the breast tissue. When they appear to be scattered and similar in appearance, they are usually benign and a biopsy or further testing is not needed.
If the calcifications are tightly clumped together, look different from one another, or have a linear appearance, a radiologist may recommend a follow-up mammogram or a biopsy.
The follow-up mammogram is used to take a closer look at the concerning calcifications to better determine if they are benign or in need of further testing. If deemed necessary, a biopsy will be recommended to check for underlying cancer. Most of the time, the biopsy will show that the calcification is not cancer.
If the calcifications are confirmed to be benign, which is most often the case, the patient can then return to their regularly scheduled mammograms.
In some cases, calcifications on a mammogram represent the earliest form of breast cancer, which is called ductal carcinoma in situ . In DCIS, the cancerous cells are in the breasts milk ducts. DCIS is very treatable and highly curable but in some cases, if left untreated, it has the potential to become invasive breast cancer.
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Can Calcifications In The Breast Turn Into Cancer
Although calcifications may indicate cancer is present, breast calcifications are not cancer and dont turn into cancer. Breast calcifications determined to be benign dont need any more tests. They dont need to be treated or removed. If the calcifications are potentially a sign of cancer, a biopsy is obtained.
What Does The Doctor Look For On A Mammogram
A radiologist will look at your mammogram. Radiologists are doctors who diagnose diseases and injuries using imaging tests such as x-rays.
When possible, the doctor reading your mammogram will compare it to your old mammograms. This can help show if any findings are new, or if they were already there on previous mammograms. Findings that havent changed from older mammograms arent likely to be cancer, which might mean you won’t need further tests.
The doctor reading your mammogram will be looking for different types of breast changes, such as small white spots called calcifications, larger abnormal areas called masses, and other suspicious areas that could be signs of cancer.
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Causes Of Breast Calcifications
One of the first points to understand is that breast calcifications are in no way related to intake of calcium in your diet. Breast calcifications are often caused due to the natural aging process. As one gets old, the body goes through various changes and deterioration. The natural changes in the breast show up as breast calcifications.
Over a period of time, blunt injury to the breast can lead to formation of calcifications in the breast. Similarly, chronic infection of sebaceous glands and mastitis can also cause breast calcifications. Fibrocystic breast condition is also associated with breast calcifications. If you had radiation therapy in the past, it can lead to the formation of breast calcifications.
Sometimes calcium gets deposited in the milk ducts and this can cause breast calcifications. If the breast arteries show deposits of calcium, then it can lead to formation of breast calcifications.
How Are Breast Calcifications Detected
Calcifications are a common find on a mammogram, with increasing prevalence after the age of 50. There are a variety of causes for calcifications, including:
Calcifications, unlike lumps, cannot be detected using touch. They can only be found using mammography or, rarely, ultrasounds.
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Lets Talk About Breast Calcifications: Worry Or Not
Lets Talk About Breast Calcifications: Worry or Not?
Breast calcifications are common and most often not a cause for concern. However, there are some calcifications in the breast that might prompt further evaluation. We as breast imaging doctors know that the need for further workup is a cause of anxiety. We hope to relieve some of that anxiety by discussing breast calcifications in detail.
Calcifications or small deposits of calcium in the breast can be seen for lots of different reasons and are something that can only be seen on imaging nothing will be felt in the breast. Many calcifications radiologists can identify as non-cancerous or benign just by looking at their shape, size and distribution .
Calcifications of all types will appear as bright white on the mammogram. Knowing that the calcifications have been present on prior mammograms is helpful, so another reason we want those comparison studies! Occasionally, these benign type calcifications may not be quite so obvious or might be new. This could prompt additional mammographic imaging.
Benign type calcifications in the breast include the following:
Breast calcifications can also be a sign of early breast cancer, a reason we radiologists pay close attention to all calcifications in the breast. The calcifications associated with breast cancer are usually quite small, often described as microcalcifications.
After reviewing the diagnostic magnification views, the radiologist will then decide:
What Are Breast Calcifications And Do They Turn Into Cancer
Breast calcifications are signs of cellular turnover essentially, dead cells that can be visualized on a mammogram or observed in a breast biopsy. In most cases, mammographic calcifications are associated with changes in benign breast tissue, though in some cases they can be a sign of early breast cancer.
All cells in the body have their own life span the cells that line the milk ducts of the breast also only live for so long. When these cells die, if they dont get cleared away by the bodys filtering system, they can remain in the duct, like debris, and show up as calcifications on mammogram.
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How Are Breast Calcifications Found
Breast calcifications are usually found by chance during a routine screening mammogram or during an investigation at a breast clinic for another breast problem. The calcifications show up on a mammogram as small white dots.
When you have a mammogram, the image is looked at by one or more radiologists or specialist practitioners . When calcifications are found, they will look carefully at:
- their size such as large or small
- their shape such as round, popcorn like or large rod like
- their pattern such as scattered, in a line or in a group
They will categorise the calcifications as looking benign, indeterminate or suspicious of being cancer.
What Happens If My Doctor Finds Breast Calcifications On My Mammogram
If you have macrocalcifications, no further testing or treatment is needed, because they are not harmful. If microcalcifications are seen on your mammogram, another mammogram may be performed to get a more detailed look at the area in question. The calcifications will be determined to be either “benign,” “probably benign,” or “suspicious.”
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When To See A Doctor
If your radiologist suspects that your breast calcifications are associated with precancerous changes or breast cancer, you may need to have another mammogram with magnification views to get a closer look at the calcifications. Or the radiologist may recommend a breast biopsy to test a sample of breast tissue.
Your radiologist may request any prior mammogram images to compare and determine if the calcifications are new or have changed in number or pattern.
If breast calcifications appear to be caused by a benign condition, your radiologist may recommend a six-month follow-up for another mammogram with magnification views. The radiologist checks the images for changes in the shape, size and number of calcifications or whether they remain unchanged.
Benign Breast Calcifications: Not Cancer
Calcifications are common in the breast, and regardless of the cause they will appear on the mammogram. An experienced radiologist can quickly tell the difference from benign breast calcifications and those associated with breast carcinoma.
However, epidermal and dermal breast calcifications can take the form of moles with crevices. Also, sweat glands often develop round or oval, lucent-centered calcifications. Dermal breast calcifications are very common.
Vascular calcifications may also develop in the breast. Typically they are linear, and when they originate in arteries they appear in a parallel tram track-like formation. In very rare instances, vascular calcifications can arise from venous calcification in Mondors disease.
Dystrophic calcifications are brownish, and are essentially scars or rather calcium deposits accumlating in scar tissue. These calcifications tend to be dense, coarse, large, and irregular in shape. Furthermore, dystrophic calcifications develop in stromal tissues, .
Dystrophic calcifications in the breast can result from many sources, including hematoma, fibrooadenoma, abscess, or may form in the fibrous capsules around implants. They can also appear post-surgery or post-radiation, or due to fat necrosis.
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Why Do Breast Calcifications Form
Calcifications are usually non-cancerous changes in the breast tissue associated with aging. But there are various causes for calcifications your breast health provider will work to determine the cause of any breast calcification to ensure that the changes seen on a patient’s mammogram are not cancerous.
The Operation Removing The Calcification
Once the hookwire is in position you will be taken to the operating theatre. The operation will be performed under general anaesthetic. The surgeon will remove the piece of tissue at the tip of the wire. Once the tissue is removed, it will be returned to the imaging department where an X-ray of the tissue will be performed to confirm that the calcification is in the tissue that has been successfully removed. The specimen will then be sent to the pathologist.
Post hookwire insertion
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They Say I Have Breast Cancer From Calcifications
Hi there rictina….
bless ya, there’s lots of us breast cancer ladies here … all different stages and different treatments … and our who’s old hand at all this, she’s our original breast lady … I’m nearly 9 months post mastectomy… others followed me, and we now have 3 having their ops this week … so your deffinatly not on your own … and they will all make you welcome … and anything you need to know, at least one of us will have been there too …
I’m back in hosp on 18th with lumps that they said look like calcification. . So I’m there with you … pesky little blighters ….. we can do this … we were all scared at first , l think it’s the thought of the unknown …and trust me, we have down days … and good days, but on here you can say almost anything …
If you want to look back on others journey on here … there’s a thread started by rilleyroo … there’s lots of it but it’s a great informative read and you can see how others got through those early scary days … and take heart, wer all still here, holding each other up and if I could go back in time , I would tell myself … live in the day … no looking too far ahead … no more “what ifs” and go with the flow … take those feelings and go with them … cry, scream, yell at the unfairness.. and then get back on this rollercoaster of ours and hold on tight, it’s a bumpy ride …