Evaluation of mammographic calcification

Breast calcifications can be classified into ductal, lobular, or miscellaneous types. Analysis is less difficult using this classification. Frequently, the characterization of miscellaneous types is straightforward. The analysis of ductal type and lobular type microcalcifications is more challenging. If they are scattered, the most important determination is whether or not there are casting calcifications present. If so, malignancy cannot be excluded. If clustered, then analysis of their form becomes critical. Teacup or pearl type calcifications are benign. Granular or casting calcifications are malignant. Mammographic calcifications that appear obviously malignant or highly suspicious for malignancy warrant biopsy whether or not a mass is clinically palpable. If calcifications are obviously benign, then routine follow-up at four to six month intervals if there is a high probability that they are benign. Otherwise, they are biopsied at the discretion of the clinician.