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When you see calcifications on a mammogram, what are your next steps to determine if further tests are needed?
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amooremd (Physician - Radiology (Verified) ) - 04 / 02 / 2012
Calcifications are very common in the breast. When we see calcifications on a mammogram, it is important to characterise them as large or small, clustered, grouped, or solitary, and regular or smooth looking, versus irregular in appearance. Although nothing in Medicine is 100% and there are exceptions to every rule, benign calcifications are usually large, smooth and either single or several. Sometimes if we aren't sure about calcifications we will perform magnification views that will enlarge the area in question and also spread out the tissue to make it easier to see the calcifications. It is also important to look at the previous mammograms to see if they were there before. Benign, large calcifications tend to look the same year after year. If the patient has never had a mammogram before, or if they were not there last year but they look totally benign, you might recommend six month followup. This is done if we are as sure as we can be that the findings are benign but because there is a change we are being extra cautious. The American College of Radiology came up with the 6 month interval because they felt that any sooner would not be enough time to see a change, and any longer would be too long.
If the calcifications look irregular, small and clustered then we recommend a biopsy of the area. Sometimes we will also perform ultrasound to see if we can identify a small mass in the area in question.
If the calcifications look irregular, small and clustered then we recommend a biopsy of the area. Sometimes we will also perform ultrasound to see if we can identify a small mass in the area in question.
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