Breast Calcification- Do You Need to Worry?

Breast calcification is the deposits of calcium detected in the breast. This condition is most commonly seen affecting females older than 50 years. Most of the breast calcifications are benign. It is important to understand these changes as they can be an early sign of conditions which include ductal carcinoma in situ or invasive breast cancer. Research indicated that 12.7-41.2% of females in breast cancer screening programs are brought for an additional clinical assessment for warning signs of cancer.⁽¹⁾

Breast calcifications are seen as white dots on the x-ray and are not detected in ultrasounds and MRI scans.

Breast calcification is of two different types. In some people, calcification is a mix of both of its types.

These appear as large white dots and are known to occur randomly throughout the breast tissue. They are greater than 0.5 mm in diameter. This is a common type and is mostly considered benign and does not require the people to follow up.

This calcification appears as tiny white specs and is mostly benign. Their certain characteristics may indicate them to be cancerous. These characteristics include:

• Being 0.5 mm in diameter
• Have different sizes and shapes
• Occurring in clusters in an area of the breast

Sometimes the calcifications are seen to occur outside the breast tissue, which may be on the skin and on the inside the blood vessels.

It occurs on the skin due to the use of deodorants, lotions, or powder. These products appear as white dots in the x-ray result. Therefore, it is important to avoid these things before going for any screening.

No further testing is required for the calcification outside the breast tissue.

Breast tissue can occur due to the following reasons:

• Trauma or injury after any surgery
• Infection
• Ductal carcinoma in situ, which is the most common cause of calcifications in the breast
• Fat necrosis
• Cysts in the breast
• Calcium build-up in the breast
• Radiation therapy for breast cancer
• Invasive breast cancer
• Fibroadenoma, a benign breast tumor

A study done in 2019, showed a link between the lifetime breastfeeding duration and the presence of microcalcification clusters.⁽²⁾ The risk factors include:

• Person history of cancer of the breast
• Family history of cancer
• A genetic predisposition to breast cancer
• Eating food rich in calcium is not a reason or risk factor for breast calcification at all.

If calcifications are detected in a mammogram, it is decided by a radiologist if further testing is needed. Macrocalcifications are not considered suspicious and are very less likely to require a follow-up. If large calcification occurs along with microcalcification, further testing is advised.

If the calcification is considered suspicious another mammogram may be advised, prior mammogram images are checked to look for changes in calcifications, and the case is referred to a doctor.

The doctor reviews the x-ray images and the radiology report. A biopsy may be done to test the breast tissue. He may also recommend an MRI scan.

A person with breast calcification is recommended to be screened every 6 months to look for changes in calcifications.

A small piece of breast tissue is taken to be examined in breast biopsy. There are two types of biopsies to check calcifications, which include:

• Stereotactic Core Needle Biopsy: In this, a needle is inserted in the breast tissue using computer imaging. A piece of calcified tissue is removed under local anesthesia.
• Surgical Biopsy: It is when the surgeon removes the abnormal tissue under local or general anesthesia which is then sent for testing.

A surgical biopsy is recommended if the core needle biopsy is unsuccessful.

If the calcification is benign, no treatment is needed. If the calcifications are associated with other medical conditions such as mammary duct ectasia further information is provided about the available treatments.

If breast cancer is indicated, treatment may be needed to stop the spread of cancer and kill the cancerous cells. The treatment depends on the type of cancer, its size, and its stage.

Surgery, chemotherapy, radiation therapy, and hormone therapy are the best treatments for breast cancer.

Breast calcification may indicate early breast cancer and is mostly detected in mammogram screening. They should not be ignored and quick action should be taken towards the treatment.