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

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.