Detection of calcifications in breast biopsies by scanning electron microscopy

The identification of microcalcifications in breast biopsy specimens is a common and important task for the surgical pathologist that may sometimes be problematic. Although visualized by preoperative mammographic and operative specimen radiography, some cases may fail to reveal calcifications by histopathologic examination or occasion laborious and time-consuming study to confirm sparse calcifications. The present study demonstrates how conventional bright-field and polariscopic light microscopy did require considerable effort to confirm rare calcification. On the other hand, scanning electron microscopy was employed directly on a routine slide and provided definitive visual and physical proof, e.g., by means of energy dispersive x-ray microanalysis of a rare calcification on a slide previously judged to be negative for calcium and in a short period of time. Recent instrument advances in high voltage beam stabilization and in the ability to vary the pressure of the scanning electron microscope in the vicinity of the specimen now allow complete insertion of a diagnostic glass slide with only trivial preparation. The report, although brief, raises important questions regarding the extent and prevalence of breast calcifications.