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Coarse Heterogeneous Calcifications
Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Coral-type calcifications (Ca⁺⁺)
            • Definitions

              • Irregular, conspicuous Ca⁺⁺, usually > 0.5 mm; vary in size and shape; tend to coalesce or aggregate, compound morphology
              • Distinguish from fine pleomorphic Ca⁺⁺: Vary in size and shape, shard-like, usually < 0.5 mm
              • Group: ≥ 5 Ca⁺⁺ in 1-cm span, or more Ca⁺⁺ spanning up to 2 cm

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              • Image Interpretation Pearls

                                Selected References

                                1. Candelaria RP et al: Analysis of stereotactic biopsies performed on suspicious calcifications identified within 24 months after completion of breast conserving surgery and radiation therapy for early breast cancer: Can biopsy be obviated? Am J Surg. 215(4):693-698, 2018
                                2. Bennani-Baiti B et al: MR imaging for diagnosis of malignancy in mammographic microcalcifications: A systematic review and meta-analysis. Radiology. 283(3):692-701, 2017
                                3. Grimm LJ et al: Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors. Eur Radiol. 27(6):2275-2281, 2017
                                4. Kim SY et al: Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS. Ann Surg Oncol. 22(9):2895-901, 2015
                                5. Sickles EA et al: Breast Imaging Reporting and Data System, BI-RADS: Mammography. 5th ed. Reston: American College of Radiology, 2013
                                6. Bent CK et al: The positive predictive value of BI-RADS microcalcification descriptors and final assessment categories. AJR Am J Roentgenol. 194(5):1378-83, 2010
                                7. Burnside ES et al: Use of microcalcification descriptors in BI-RADS 4th edition to stratify risk of malignancy. Radiology. 242(2):388-95, 2007
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Pathology

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Synonyms

                                            • Coral-type calcifications (Ca⁺⁺)
                                          • Definitions

                                            • Irregular, conspicuous Ca⁺⁺, usually > 0.5 mm; vary in size and shape; tend to coalesce or aggregate, compound morphology
                                            • Distinguish from fine pleomorphic Ca⁺⁺: Vary in size and shape, shard-like, usually < 0.5 mm
                                            • Group: ≥ 5 Ca⁺⁺ in 1-cm span, or more Ca⁺⁺ spanning up to 2 cm

                                          IMAGING

                                          • General Features

                                            • Mammographic Findings

                                              • Ultrasonographic Findings

                                                • MR Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • Microscopic Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          DIAGNOSTIC CHECKLIST

                                                          • Consider

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Candelaria RP et al: Analysis of stereotactic biopsies performed on suspicious calcifications identified within 24 months after completion of breast conserving surgery and radiation therapy for early breast cancer: Can biopsy be obviated? Am J Surg. 215(4):693-698, 2018
                                                              2. Bennani-Baiti B et al: MR imaging for diagnosis of malignancy in mammographic microcalcifications: A systematic review and meta-analysis. Radiology. 283(3):692-701, 2017
                                                              3. Grimm LJ et al: Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors. Eur Radiol. 27(6):2275-2281, 2017
                                                              4. Kim SY et al: Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS. Ann Surg Oncol. 22(9):2895-901, 2015
                                                              5. Sickles EA et al: Breast Imaging Reporting and Data System, BI-RADS: Mammography. 5th ed. Reston: American College of Radiology, 2013
                                                              6. Bent CK et al: The positive predictive value of BI-RADS microcalcification descriptors and final assessment categories. AJR Am J Roentgenol. 194(5):1378-83, 2010
                                                              7. Burnside ES et al: Use of microcalcification descriptors in BI-RADS 4th edition to stratify risk of malignancy. Radiology. 242(2):388-95, 2007