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Typically Benign Calcifications
Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Calcifications (Ca⁺⁺)
              • Breast arterial calcifications (BAC)
            • Synonyms

              • Dermal: Skin Ca⁺⁺
              • Rim Ca⁺⁺: Lucent-centered, eggshell
                • Dystrophic Ca⁺⁺ often lucent centered (especially early on), often start as calcifying oil cysts
              • Large rod-like: Secretory Ca⁺⁺
            • Definitions

              • Typically benign Ca⁺⁺ include dermal, vascular, coarse popcorn-like, large rod-like, round, rim, dystrophic, and suture
                • Round: Smooth, spherical or ovoid Ca⁺⁺; "punctate" Ca⁺⁺ = subset of round Ca⁺⁺ (< 0.5 mm)
              • Milk of calcium Ca⁺⁺: Fine, powdery amorphous Ca⁺⁺ precipitated in microcysts
                • Layer, more conspicuous on true lateral (90°) view; smudgy on craniocaudal view
                • Can coexist with suspicious Ca⁺⁺
                • Can be dismissed as benign when typical in appearance

            IMAGING

            • General Features

              • Mammographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Microscopic Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Kaltenbach B et al: A matrix of morphology and distribution of calcifications in the breast: Analysis of 849 vacuum-assisted biopsies. Eur J Radiol. 86:221-226, 2017
                                  2. Hendriks EJ et al: Breast arterial calcifications: a systematic review and meta-analysis of their determinants and their association with cardiovascular events. Atherosclerosis. 239(1):11-20, 2015
                                  3. Graf O et al: Large rodlike calcifications at mammography: analysis of morphologic features. AJR Am J Roentgenol. 200(2):299-303, 2013
                                  4. Sickles EA et al. ACR BI-RADS Mammography. ACR BI-RADS Atlas, Breast Imaging Reporting and Data System. Reston, VA: American College of Radiology, 2013
                                  5. Demetri-Lewis A et al: Breast calcifications: the focal group. AJR Am J Roentgenol. 198:W325-43, 2012
                                  6. Sickles E: Breast calcifications: Mammographic evaluation. Radiology. 160:289-93, 1986
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Clinical Issues

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Calcifications (Ca⁺⁺)
                                              • Breast arterial calcifications (BAC)
                                            • Synonyms

                                              • Dermal: Skin Ca⁺⁺
                                              • Rim Ca⁺⁺: Lucent-centered, eggshell
                                                • Dystrophic Ca⁺⁺ often lucent centered (especially early on), often start as calcifying oil cysts
                                              • Large rod-like: Secretory Ca⁺⁺
                                            • Definitions

                                              • Typically benign Ca⁺⁺ include dermal, vascular, coarse popcorn-like, large rod-like, round, rim, dystrophic, and suture
                                                • Round: Smooth, spherical or ovoid Ca⁺⁺; "punctate" Ca⁺⁺ = subset of round Ca⁺⁺ (< 0.5 mm)
                                              • Milk of calcium Ca⁺⁺: Fine, powdery amorphous Ca⁺⁺ precipitated in microcysts
                                                • Layer, more conspicuous on true lateral (90°) view; smudgy on craniocaudal view
                                                • Can coexist with suspicious Ca⁺⁺
                                                • Can be dismissed as benign when typical in appearance

                                            IMAGING

                                            • General Features

                                              • Mammographic Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Microscopic Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Kaltenbach B et al: A matrix of morphology and distribution of calcifications in the breast: Analysis of 849 vacuum-assisted biopsies. Eur J Radiol. 86:221-226, 2017
                                                                  2. Hendriks EJ et al: Breast arterial calcifications: a systematic review and meta-analysis of their determinants and their association with cardiovascular events. Atherosclerosis. 239(1):11-20, 2015
                                                                  3. Graf O et al: Large rodlike calcifications at mammography: analysis of morphologic features. AJR Am J Roentgenol. 200(2):299-303, 2013
                                                                  4. Sickles EA et al. ACR BI-RADS Mammography. ACR BI-RADS Atlas, Breast Imaging Reporting and Data System. Reston, VA: American College of Radiology, 2013
                                                                  5. Demetri-Lewis A et al: Breast calcifications: the focal group. AJR Am J Roentgenol. 198:W325-43, 2012
                                                                  6. Sickles E: Breast calcifications: Mammographic evaluation. Radiology. 160:289-93, 1986