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

Prerna Garg1, Jitin Goyal1, Rupinder Singh1

  • 1Department of Radiology, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, 110085 India.

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Summary

Grouped amorphous microcalcifications on mammograms have a low positive predictive value (PPV) for malignancy, under 10%. This finding suggests a potential reclassification to a less concerning imaging category, as risk factors did not significantly alter the PPV.

Keywords:
ACR-BIRADSBreast cancerGrouped amorphous microcalcificationsPositive predictive value (PPV)Screening mammography

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Area of Science:

  • Radiology
  • Oncology
  • Pathology

Background:

  • Grouped amorphous microcalcifications are a common mammographic finding.
  • Evaluating their positive predictive value (PPV) is crucial for accurate breast cancer screening.
  • Understanding associations with risk factors can refine diagnostic strategies.

Purpose of the Study:

  • To determine the PPV of grouped amorphous microcalcifications detected on screening mammography.
  • To investigate the association between these microcalcifications and breast cancer risk factors.
  • To assess the potential for reclassification of these findings within the ACR-BIRADS system.

Main Methods:

  • A retrospective observational study of 61 patients with grouped amorphous microcalcifications requiring biopsy.
  • Pathology results (benign, high-risk, malignant) were used as the reference standard.
  • Data on patient age, breast density, menopausal status, and risk factors were collected and analyzed.

Main Results:

  • The overall PPV for malignancy was 8.06% (2/61 malignant, 3/61 high-risk).
  • The malignancy rate, excluding high-risk lesions, was 3.3%.
  • No statistically significant association was found between PPV and age, breast density, menopausal status, or other risk factors.

Conclusions:

  • Grouped amorphous microcalcifications have a low PPV (<10%), suggesting they may warrant an ACR-BIRADS 4a classification.
  • Neither menopausal status nor dense breasts predicted malignancy in this patient group.
  • The PPV of these microcalcifications is independent of common breast cancer risk factors.