Grouped Amorphous Micro-Calcifications Detected on Screening Mammogram: Single Tertiary Centre Experience

The study was aimed at evaluating the positive predictive value (PPV) of grouped amorphous microcalcifications detected on screening mammography and its association with known risk factors of breast cancer. A retrospective observational study was conducted on 61 patients who underwent stereotactic or vacuum-assisted biopsy (VABB) for grouped amorphous microcalcification only lesions detected on screening mammography. The pathology results were reviewed to determine whether these microcalcifications only lesions were benign, high-risk, or malignant lesions. The patient's age, breast density, menopause, and risk factors, if any, were recorded and tabulated. The PPV for malignancy was calculated, considering histopathology results as the reference standard. Of the 61 patients with screen-detected grouped amorphous microcalcifications, biopsy results revealed that two cases (3.3%) were malignant, three cases (4.9%) were high-risk lesions (e.g., atypical ductal hyperplasia), and the rest were benign (91.9%). The positive predictive value for malignancy was approximately 8.06%. No statistically significant difference was noted between the PPV of amorphous microcalcifications between low risk vs. high risk, breast density, age (less than equal to 50), or menopausal status. Neither being postmenopausal nor having dense breasts was found to be predictive of malignancy in patients with amorphous microcalcifications. Grouped amorphous microcalcifications detected on screening mammography have a PPV of less than 10%, thus suggesting that an ACR-BIRADS 4a category may be more appropriate. If high-risk cases were excluded, we found a malignancy rate of only 3.3%. PPV of grouped amorphous calcification does not vary with age, breast density, menopausal status, or other risk factors.