Breast calcifications are small deposits of calcium in the breast tissue. They often show up in mammograms and are most common in women over 50. Breast calcifications are typically noncancerous, or benign. However, some forms can occasionally indicate breast cancer.
This article looks at the causes of breast calcifications, and we discuss what may happen if they show up on a screening test.
Calcifications are small calcium deposits that develop in the breasts. They do not cause symptoms, and a doctor cannot diagnose them from a routine breast check.
Most breast calcifications are benign. However, clusters of calcium deposits can suggest early breast cancer. Some research indicates
While calcifications do not develop into cancer, they can suggest an underlying process that is connected to breast cancer.
Two types of breast calcifications can appear on mammograms — macrocalcifications and microcalcifications. Some women have a mix of both.
Macrocalcifications appear as large white dots that occur randomly throughout the breast tissue. They are greater than 0.5 millimeters (mm) in diameter.
Macrocalcifications are very common, and doctors usually consider them to be benign. As a result, people with macrocalcifications in the breast usually require no follow-up testing.
Microcalcifications appear as tiny white specks or grains. Many cases of microcalcifications are benign. However, if they have certain characteristics, they may indicate an underlying cancerous process.
Doctors usually regard microcalcifications as suspicious and in need of further investigation if they have the following characteristics:
- They are less than 0.5 mm in diameter.
- They occur in clusters in one area of the breast.
- They differ in size and shape.
Calcifications outside the main breast tissue
Occasionally, a mammogram may show calcifications outside of the main breast tissue. These may appear to be on the skin or inside the blood vessels.
Those on the skin may be due to deodorant, lotions, or powder residue that causes white dots to appear on the X-ray results. For this reason, people should avoid applying any skin products before the screening.
Once the radiologist confirms the location as being outside of the breast tissue itself, then these types of calcifications require no further testing.
Calcifications can occur in the breast tissue as a result of:
- ductal carcinoma in situ (DCIS), a cancer of the cells that line the milk ducts
- trauma from injury or surgery
- calcium buildup in the breast, similar to atherosclerosis in the blood vessels
- cysts, fluid-filled sacs in the breast
- mammary duct ectasia, or clogged milk ducts
- fat necrosis, or dead fat cells
- fibroadenoma, a benign breast tumor
- radiation therapy for breast cancer
- invasive breast cancer
Any of the above factors can cause breast calcifications to develop.
DCIS is the most common type of cancer diagnosed in people with breast calcifications.
Other factors that increase risk include:
- a personal history of breast cancer
- a family history of breast cancer
- a genetic predisposition to breast cancer, such as having a BRCA1 and BRCA2 mutation
Eating calcium-rich foods does not cause breast calcifications.
If calcifications appear on a mammogram, the radiologist will decide if further investigation is necessary. Generally, they do not consider macrocalcifications suspicious. Standard sizes and shapes of calcifications are also less likely to require a follow-up.
However, if large calcifications occur in clusters or alongside microcalcifications, the radiologist may advise further testing.
If they consider the calcifications to be suspicious, they may:
- perform another mammogram to view the calcifications more closely
- check prior mammogram images to look for changes in calcification characteristics
- refer the case to a doctor
A doctor may:
- review the X-ray images and radiology report
- take a biopsy to test the breast tissue for signs of cancer
- recommend a breast MRI scan
- recommend screening every 6 months to check for changes to the calcifications
People who have a history of breast cancer or are at a high risk of cancer development should see their doctor if calcifications appear on a mammogram. A doctor will consider these risk factors when deciding on further testing.
A breast biopsy involves removing a small piece of breast tissue to examine it closely. There are two types of biopsies to test breast calcifications.
Stereotactic core needle biopsy is when a doctor inserts a needle into the breast, using computer imaging, to remove a piece of calcification tissue under local anesthetic. A surgical biopsy is when a surgeon removes the abnormal tissue sample under local or general anesthetic and sends it to a lab for examination.
Doctors typically only perform a surgical biopsy if a core needle biopsy is unsuccessful or if the results are inconclusive.
Before undergoing a surgical biopsy, individuals should discuss scarring, anesthesia, or recovery concerns with their surgeon.
Benign calcifications do not require any treatment. However, if the calcifications are associated with another medical condition, such as mammary duct ectasia, a doctor will provide the person with more information on the condition and available treatments.
If the calcifications indicate breast cancer, the person will require treatment to stop the spread of cancer and kill the cancerous cells. The type of treatment a person will need depends on the type of breast cancer, its size and stage, and other factors.
Potential treatments for breast cancer include:
Breast calcifications can indicate early breast cancer, which highlights the importance of having regular screening mammograms. However, most calcifications are benign and do not need follow-up investigations or treatment.
If a radiologist considers the calcifications suspicious, they will perform another mammogram and may recommend a biopsy.