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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Amorphous breast calcifications: is BI-RADS 4a appropriate?

Tatiane Mendes Gonçalves de Oliveira1, Rafael Melo Seksenian1, José Galdino Souza Santana1

  • 1Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil.

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|May 11, 2023
PubMed
Summary

Amorphous calcifications in breast tissue have a 9.42% positive predictive value (PPV) for malignancy. A history of breast cancer significantly increases the risk, highlighting the need for careful evaluation of these findings.

Keywords:
Biopsy/methodsBreast neoplasmsCalcinosis/diagnostic imagingCalcinosis/pathology

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Area of Science:

  • Radiology
  • Oncology
  • Pathology

Background:

  • Amorphous calcifications are a common finding in mammography.
  • Their association with malignancy requires further investigation to guide clinical management.

Purpose of the Study:

  • To determine the positive predictive value (PPV) of amorphous calcifications.
  • To identify imaging variables influencing malignancy risk in amorphous calcifications.

Main Methods:

  • Retrospective analysis of 138 stereotactic vacuum-assisted biopsies for amorphous calcifications.
  • Biopsies performed between January 2012 and December 2017.
  • Minimum one-year follow-up or surgical treatment based on histopathology.

Main Results:

  • The PPV of amorphous calcifications for malignancy was 9.42%.
  • Malignant cases often involved invasive carcinoma or high-grade ductal carcinoma in situ.
  • Malignancy risk was 6.15 times higher with a personal/family history of breast or ovarian cancer.
  • Postmenopausal status and dense breasts were not predictive of malignancy.

Conclusions:

  • Amorphous calcifications have a PPV of 9.42%, warranting histopathological analysis (BI-RADS 4a).
  • A history of breast cancer significantly elevates malignancy risk associated with amorphous calcifications.
  • Clinical, radiologic, and histopathologic correlation is crucial for managing amorphous calcifications.