Large rodlike calcifications at mammography: analysis of morphologic features

The purpose of this article is to prospectively determine the prevalence and morphologic features of typically benign large rodlike calcifications at mammography and to provide evidence-based data for this descriptor in a future version of the BI-RADS lexicon.

In the 1-year period of 2011, large rodlike calcifications were detected in 239 of 7935 (3%) consecutive women undergoing screening or diagnostic mammography. Analysis of morphologic features was performed in 165 of the 239 women (69%; mean age, 71.1 years; range, 39-86 years), who had a minimum number of six calcific particles and in whom benignity was assessed by lack of suspicious change compared with prior mammograms. Two of the 165 women had undergone a mastectomy previously.

The mean length of the longest calcification was 4.2 (SD, 2.4) mm (median, 3.5 mm; range, 1-14 mm). The mean width of the widest calcification was 0.6 (SD, 0.5) mm (median, 0.5 mm; range 0.2-3 mm). Bilaterality was found in 131 of 163 women (80.4%) with two breasts, periductal calcifications were found in 18 of 165 women (10.9%), and branching calcifications were found in another 18 women (10.9%). One hundred fifty-five of 165 women (93.9%) had almost entirely fat or scattered areas of fibroglandular tissue; 10 women (6.1%) had heterogeneously dense or extremely dense tissue.

Our results partially contradict the current description (size, diameter, and bilaterality versus unilaterality) of large rodlike calcifications in the BI-RADS lexicon. Content for this descriptor should be modified in a future version of the lexicon.