Calcifications (calcium deposits) or microcalcifications (small calcium deposits) are the smallest particles visible on a mammogram. Calcifications are a normal occurrence in aging breast tissues which have gone through changes that cause death of cells, such as cysts, injuries or mastitis (infection). However, they can also be a sign that cancer may be present. Because of the potential for a malignancy, radiologists study closely the findings of microcalcifications found during mammography.
A finding that would point toward further evaluation would be clustered microcalcifications—four or more close together. A finding of clustered calcium deposits, or calcifications that follow the path of a duct, would be looked at closely by a radiologist, studying the shape and placement of the calcifications. These calcium deposits are the smallest structure that mammography can visualize. Therefore, special close-up mammography views ¾ compression or magnifications ¾ will be taken to give the radiologist the best possible diagnostic picture. Calcifications associated with a malignancy have a pattern which appears to branch, with irregular shaped edges and an asymmetrical (do not look alike) shape. Often there will be a pattern of density (thickness of tissue) surrounding the calcifications that may show up on the mammogram. Sometimes the calcifications will take the shape of a duct which will alert the radiologist to a possibility of intraductal disease.
After close study looking for evidence that would give the slightest suspicion of problems, the radiologist will make a recommendation regarding treatment. If the findings do not have the characteristics of malignancy, the calcifications will be noted on the report and stated to be such. If the calcifications are suspicious, your physician may choose to wait for several months and re-examine with mammography to see if there are any changes in the area. Then, a biopsy using needle localization or stereotactic biopsy can be performed to evaluate the microcalcifications.
Mammography has given us great advantage in finding many cancers long before they are detectable by palpation (feeling). Mammography is one reason that many cancers are found in the earliest stages. Cancer that is still in the ducts is considered curable with proper treatment. Before mammography, there was no way to find cancer at such an early stage. Because most calcifications are not associated with cancer in mammography, it is essential when a finding is mentioned in a mammography report that patients understand so they do not become anxious unnecessarily. Talking with the radiologist or surgeon may be helpful.
Remember, do not wear any deodorant, powder or perfume on or near your breasts when you go for your mammogram. These may cause spots or shadows resembling microcalcifications to appear on your mammogram.