Breast calcifications are signs of cellular turnover – essentially, dead cells – that can be visualized on a mammogram or observed in a breast biopsy. In most cases, mammographic calcifications are associated with changes in benign (normal) breast tissue, though in some cases they can be a sign of early breast cancer.
All cells in the body have their own life span; the cells that line the milk ducts of the breast also only live for so long. When these cells die, if they don’t get cleared away by the body’s “filtering system,” they can remain in the duct, like debris, and show up as calcifications on mammogram.
If these calcifications — which look like small, white dots on a mammogram — appear to be loosely organized or scattered and are homogenous (which means they all look the same) in nature, they are usually benign calcifications and a biopsy is not indicated, according to Tari King, MD, chief of breast surgery at the Susan F. Smith Center for Women’s Cancers at Dana-Farber/Brigham and Women’s Cancer Center.
If the calcifications are tightly clumped together, look different from one another, or have a linear appearance, a radiologist may recommend a biopsy. It is important to remember however, that most of the time, biopsies that are recommended for mammographic calcifications do not turn out to be cancer, King emphasizes.
Still, “it is very important to follow through with recommendations made by the radiologist reading your mammogram. If you have an abnormal mammogram with a recommendation for biopsy or a recommendation for short term follow-up, it is important to return for the additional tests to be certain that the findings are not the early signs of breast cancer,” she says.
In some cases, calcifications on a mammogram represent the earliest form of breast cancer, which is called ductal carcinoma in situ (DCIS). In DCIS, the cancerous cells are confined to the milk ducts of the breast. DCIS is very treatable and highly curable – but in some cases, if left untreated, it has the potential to become invasive breast cancer.
During a mammogram, radiologists will also look for masses or other changes in the tissue that have developed since your last screening, and they will make an assessment of your breast density. Breasts are considered dense if the glandular and fibrous tissue makes up more than 50 percent of the breast tissue. Patients with extremely dense breasts may be at increased risk of breast cancer.
Learn more about your risk of breast cancer from the Breast Cancer Personalized Risk Assessment, Education and Prevention (B-PREP) Program at Brigham and Women’s Hospital.