From the Guidelines
New calcifications on a screening mammogram are small calcium deposits that have appeared in breast tissue since your previous mammogram, and while they are often benign, they require evaluation because some patterns can indicate early breast cancer. These calcifications are common findings, but they need to be assessed further to determine their significance. When new calcifications are found, your doctor will typically recommend additional imaging such as magnification views or a diagnostic mammogram to better characterize them. The radiologist will assess their number, size, shape, and distribution pattern, as described in the American College of Radiology (ACR) Breast Imaging Reporting and Data System Atlas (BI-RADS Atlas) 1.
Some key points to consider about new calcifications on a screening mammogram include:
- Round, smooth calcifications scattered throughout the breast are usually harmless and related to normal aging, benign cysts, or previous inflammation.
- Clustered, linear, or irregularly shaped calcifications in a segmental distribution may raise concern and require a biopsy for definitive diagnosis, as they can be associated with a higher risk of malignancy 1.
- The importance of regular mammogram screening is that it allows radiologists to compare images over time and identify these changes early when treatment is most effective if cancer is present.
- Approximately 80% of biopsied calcifications turn out to be benign, so it's essential not to panic if new calcifications are found.
In terms of the next steps, a diagnostic mammogram or additional imaging may be recommended to further evaluate the new calcifications, as outlined in the ACR appropriateness criteria for imaging after breast surgery 1. The goal of these additional tests is to determine whether the calcifications are benign or if they require further investigation, such as a biopsy. By prioritizing the evaluation of new calcifications on a screening mammogram, healthcare providers can help ensure that any potential breast cancer is detected and treated early, when it is most curable.
From the Research
New Calcifications on Screening Mammography
New calcifications on a screening mammogram can be an indicator of various conditions, including breast cancer.
- The presence of microcalcification on mammography is one of the earliest signs in breast cancer detection 2.
- However, it is difficult to distinguish malignant calcifications from benign calcifications 2.
- A study found that the pattern of increased extent of microcalcification on screening mammography was a significant predictor for breast cancer 2.
- Another study found that grouped amorphous calcifications identified on screening mammography contribute minimally to detection of breast cancer and are not thought to be associated with any identifiable improvement in prognosis 3.
Types of Calcifications
There are different types of calcifications that can appear on a mammogram, including:
- Benign calcifications, which are common and usually not a cause for concern 4, 5.
- Malignant calcifications, which can be an indicator of breast cancer 4, 5.
- Vascular calcifications, which can be an indicator of peripheral vascular disease 6.
Next Steps
If new calcifications are detected on a screening mammogram, the next steps may include: