Intermediate to highly suspicious calcification in breast lesions: a radio-pathologic correlation

• Published in: Breast cancer research and treatment Vol. 110; no. 1; pp. 1 - 7
• Main Authors: Tse, Gary M., Tan, Puay-Hoon, Cheung, Humairah S., Chu, Winnie C. W., Lam, Wynnie W. M.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-07-2008; Springer; Springer Nature B.V
• Subjects: Biological and medical sciences; Biopsy; Breast cancer; Breast Diseases - diagnostic imaging; Breast Diseases - pathology; Calcinosis - diagnostic imaging; Calcinosis - pathology; Calcium; Cancer research; Female; Gynecology. Andrology. Obstetrics; Humans; Mammary gland diseases; Mammography; Medical diagnosis; Medical sciences; Medicine; Medicine & Public Health; Oncology; Pathology; Radiology; Review; Tumors; Breast; Calcification; Cancer; Mammary gland; Lesion; Malignant tumor
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-007-9695-4

Breast calcification is an important feature in the radiological assessment of breast lesions. There are well established diagnostic criteria basing on the morphology and distribution of the calcifications radiologically with recommendation protocols. Pathologically, calcifications in breast lesions are of dystrophic type, and may occur in either the secretory materials or necrotic debris, with inflammation and osteopontin being plausible mediators. Detection of calcium phosphate (hydroyapaptite) is considerably easier than calcium oxalate. Radiologically amorphous calcification represents a borderline type of calcification, and occurs in both benign and malignant (low grade) lesions, and warrants careful follow up and investigation. Clustering of calcification alone may not be an accurate predictor for malignancy, but when there are associated features like pleomorphism, branching, architectural distortion, and associated mass or density, the predictive value for malignant increases. Adequate sampling of calcification in the biopsy is crucial in the management of patients; in general, needle core biopsy or mammotome biopsy achieve satisfactory calcification retrieval. In a benign biopsy that fails to identify the calcifications visible in the mammography, further evaluation or cutting of the histologic block is recommended to minimize the potential of a false negative investigation.