CALCIFICATIONS adobe acrobat pdf of 'Total Mastectomy (No Reconstruction)'

This is a common finding on mammograms. This is the most difficult of mammogram findings to characterize. These show up as tiny specks on imaging.

Calcifications have nothing to do with the amount of calcium in a patientís diet. Anything that is liquid, in general, gets hard and crystallizes when it dries. In the breast, these hardened particles are a result of the liquid precipitation within the duct.

Most commonly, 70% of calcifications is normal fibrocystic hyperplasia: thickening of the lining of the duct space causes fluid to be trapped and dry. In approximately 15% of cases, the thickened duct lining can begin to change and look abnormal, atypical ductal hyperplasia (ADH). In the remaining 15% of cases, the calcifications can indicate early cancer, ductal carcinoma in-situ (DCIS).

If calcifications are seen on a routine mammogram, a diagnostic mammogram should then be done. This is a mammogram that will focus on the area of calcifications so that they may be better visualized. Sometimes, they will look benign on further imaging and no further investigation/treatment is needed. If after diagnostic mammogram the etiology of the calcifications remains unclear, then a stereotactic biopsy is indicated. A six months follow-up mammogram study is NOT appropriate for calcifications.

Benign fibrocystic calcifications require no treatment. Only ADH and DCIS would be recommended for removal: excision with wire localization or partial mastectomy with wire localization respectively.

Dr. Arlene E. Ricardo, M.D.