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Breast
Lesion Imaging Characteristics
Calcifications, Typically Benign
Milk of Calcium
Milk of Calcium
Nicole S. Winkler, MD; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Milk of calcium (MOC)

            • Synonyms

              • Benign, intracystic calcifications (Ca⁺⁺)
              • Sedimented calcium crystals within fluid

            • Definitions

              • MOC: Radiologic term for calcifications that settle dependently in micro- or macrocysts, resulting in changeable morphology from one mammographic view to another
              • Component of fibrocystic change

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Image-Guided Biopsy

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Oligane HC et al: Grouped amorphous calcifications at mammography: frequently atypical but rarely associated with aggressive malignancy. Radiology. 288(3):671-9, 2018
                                            2. Ghammraoui B et al: Investigating the feasibility of classifying breast microcalcifications using photon-counting spectral mammography: a simulation study. Med Phys. 44(6):2304-2311, 2017
                                            3. Ghammraoui B et al: Non-invasive classification of breast microcalcifications using x-ray coherent scatter computed tomography. Phys Med Biol. 62(3):1192-1207, 2017
                                            4. Hicks DG et al: Nonproliferative changes. In Diagnostic Pathology: Breast. 2nd ed. Philadelphia, PA: Elsevier, 2016
                                            5. Sickles EA et al: Breast Imaging Reporting and Data System, BI-RADS: Mammography. 5th ed. Reston, VA: American College of Radiology, 2013
                                            6. Park JS et al: Carcinoma mixed within milk of calcium in a breast: a case report. Korean J Radiol. 9 Suppl:S7-9, 2008
                                            7. D'Orsi CJ et al: Breast Imaging Reporting and Data System: BI-RADS, Mammography. 4th ed. Reston, VA: American College of Radiology, 2003
                                            8. Berg WA et al: Biopsy of amorphous breast calcifications: pathologic outcome and yield at stereotactic biopsy. Radiology. 221(2):495-503, 2001
                                            9. Moy L et al: The pendent view: an additional projection to confirm the diagnosis of milk of calcium. AJR Am J Roentgenol. 177(1):173-5, 2001
                                            10. Ross BA et al: Milk of calcium in the breast: appearance on prone stereotactic imaging. Breast J. 7(1):53-5, 2001
                                            11. Margolin FR et al: Microcystic calcifications at stereotactic breast biopsy. Breast J. 5(3):182-185, 1999
                                            12. Liberman L et al: The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories. AJR Am J Roentgenol. 171(1):35-40, 1998
                                            13. D'Orsi CJ et al: Mammographic feature analysis. Semin Roentgenol. 28(3):204-30, 1993
                                            14. Truong LD et al: Calcium oxalate in breast lesions biopsied for calcification detected in screening mammography: incidence and clinical significance. Mod Pathol. 5(2):146-52, 1992
                                            15. Tornos C et al: Calcium oxalate crystals in breast biopsies. The missing microcalcifications. Am J Surg Pathol. 14(10):961-8, 1990
                                            16. Linden SS et al: Sedimented calcium in benign breast cysts: the full spectrum of mammographic presentations. AJR Am J Roentgenol. 152(5):967-71, 1989
                                            17. Sickles EA et al: Milk of calcium within tiny benign breast cysts. Radiology. 141(3):655-8, 1981
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Milk of calcium (MOC)

                                                      • Synonyms

                                                        • Benign, intracystic calcifications (Ca⁺⁺)
                                                        • Sedimented calcium crystals within fluid

                                                      • Definitions

                                                        • MOC: Radiologic term for calcifications that settle dependently in micro- or macrocysts, resulting in changeable morphology from one mammographic view to another
                                                        • Component of fibrocystic change

                                                      IMAGING

                                                      • General Features

                                                        • Mammographic Findings

                                                          • Ultrasonographic Findings

                                                            • MR Findings

                                                              • Image-Guided Biopsy

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Oligane HC et al: Grouped amorphous calcifications at mammography: frequently atypical but rarely associated with aggressive malignancy. Radiology. 288(3):671-9, 2018
                                                                                      2. Ghammraoui B et al: Investigating the feasibility of classifying breast microcalcifications using photon-counting spectral mammography: a simulation study. Med Phys. 44(6):2304-2311, 2017
                                                                                      3. Ghammraoui B et al: Non-invasive classification of breast microcalcifications using x-ray coherent scatter computed tomography. Phys Med Biol. 62(3):1192-1207, 2017
                                                                                      4. Hicks DG et al: Nonproliferative changes. In Diagnostic Pathology: Breast. 2nd ed. Philadelphia, PA: Elsevier, 2016
                                                                                      5. Sickles EA et al: Breast Imaging Reporting and Data System, BI-RADS: Mammography. 5th ed. Reston, VA: American College of Radiology, 2013
                                                                                      6. Park JS et al: Carcinoma mixed within milk of calcium in a breast: a case report. Korean J Radiol. 9 Suppl:S7-9, 2008
                                                                                      7. D'Orsi CJ et al: Breast Imaging Reporting and Data System: BI-RADS, Mammography. 4th ed. Reston, VA: American College of Radiology, 2003
                                                                                      8. Berg WA et al: Biopsy of amorphous breast calcifications: pathologic outcome and yield at stereotactic biopsy. Radiology. 221(2):495-503, 2001
                                                                                      9. Moy L et al: The pendent view: an additional projection to confirm the diagnosis of milk of calcium. AJR Am J Roentgenol. 177(1):173-5, 2001
                                                                                      10. Ross BA et al: Milk of calcium in the breast: appearance on prone stereotactic imaging. Breast J. 7(1):53-5, 2001
                                                                                      11. Margolin FR et al: Microcystic calcifications at stereotactic breast biopsy. Breast J. 5(3):182-185, 1999
                                                                                      12. Liberman L et al: The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories. AJR Am J Roentgenol. 171(1):35-40, 1998
                                                                                      13. D'Orsi CJ et al: Mammographic feature analysis. Semin Roentgenol. 28(3):204-30, 1993
                                                                                      14. Truong LD et al: Calcium oxalate in breast lesions biopsied for calcification detected in screening mammography: incidence and clinical significance. Mod Pathol. 5(2):146-52, 1992
                                                                                      15. Tornos C et al: Calcium oxalate crystals in breast biopsies. The missing microcalcifications. Am J Surg Pathol. 14(10):961-8, 1990
                                                                                      16. Linden SS et al: Sedimented calcium in benign breast cysts: the full spectrum of mammographic presentations. AJR Am J Roentgenol. 152(5):967-71, 1989
                                                                                      17. Sickles EA et al: Milk of calcium within tiny benign breast cysts. Radiology. 141(3):655-8, 1981