From the Guidelines
Non-malignant breast calcifications are primarily caused by benign conditions such as fibrocystic changes, fibroadenomas, fat necrosis, and nonsclerosing adenosis, as evidenced by the most recent study in 2022 1. These calcifications often result from normal aging processes, with fibrocystic changes being a leading cause as women experience hormonal fluctuations throughout life. Key causes of non-malignant breast calcifications include:
- Fibrocystic changes: a common condition characterized by lumpy or rope-like breast tissue, which can lead to the formation of benign calcifications 1
- Fibroadenomas: benign breast tumors that can develop calcifications over time 1
- Fat necrosis: a condition that occurs when breast tissue is damaged, often due to trauma or surgery, and can lead to the formation of calcifications 1
- Nonsclerosing adenosis: a type of benign breast lesion that can cause calcifications 1 Inflammation from previous breast infections or fat necrosis following trauma or surgery can trigger calcification formation as part of the healing process. Additionally, certain conditions such as secretory disease, vascular calcifications, and skin calcifications can also contribute to the formation of non-malignant breast calcifications. It is essential to note that while most breast calcifications are benign, their appearance on imaging helps radiologists distinguish them from potentially concerning patterns, and regular screening and appropriate follow-up remain important to ensure they maintain benign characteristics over time.
From the Research
Causes of Non-Malignant Breast Calcifications
- Benign breast calcifications can be caused by various factors, including the presence of calcium oxalate, which is exclusively associated with benign lesions 2
- Fibroadenomatoid hyperplasia, a rare benign breast lesion, can also cause suspicious microcalcifications on mammographic screening 3
- Other causes of benign breast calcifications include fibrocystic changes, which can lead to the formation of calcifications 2, 4
Characteristics of Benign Breast Calcifications
- Benign calcifications are typically larger, coarser, round with smooth margins, and have a scattered or diffuse distribution 4
- They can also be characterized as amorphous, low to medium density, and may represent calcium oxalate 2
- Granular microcalcifications that vary in shape, size, and density, and have no associated mass, can also be a feature of benign breast calcifications, such as those seen in fibroadenomatoid hyperplasia 3
Diagnosis and Management
- The American College of Radiology's BI-RADS assessment categories and Appropriateness Criteria guidelines can help radiologists and other physicians determine appropriate action when calcifications are discovered 4, 5
- Stereotactic vacuum-assisted breast biopsy (SVAB) can be used to diagnose breast calcifications, and patients with non-malignant lesions can be followed with annual screening 6
- Re-biopsy may be necessary for patients with a discordant result of SVAB and with changes in an imaging finding during a follow-up 6