Learning objectives
-To assess the likelihood of malignancy of microcalcifications according to the BI-RADS descriptors in a digital mammography environment.
- To discuss the management of patients with suspected malignancy microcalcifications, recalling the different techniques possible to obtain histological proof.
- To understand the diagnostic and prognostic value of microcalcifications detected in the breast by mammography.
Background
Calcifications may be the first detectable sign of malignancy and allow early detection of breast cancer when screening with mammography.Detailed analysis of the characteristics of the calcifications enables the radiologist to distinguish benign lesions from malignant lesions, assess the radiological extent and distribution of the disease, and propose adequate surgical interventions.
Findings and procedure details
I/ The breast imaging reporting and Data system(BIRADS)
The most widely used system for classification is the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS).
In the fifth edition of BI-RADS, The typical suspicious calcifications morphology include: ‘’amorphous, coarse heterogeneous,fine pleomorphic and fine linear branching’’.(figure1)[Fig 1]
Distribution of calcifications has been simplified in the fifth edition by eliminating the terms scattered and clustered. The remaining distributions are termed “diffuse, segmental, regional, grouped, and linear”. The number of calcifications in the “grouped” distributionhas...
Conclusion
Many breast lesions are associated with microcalcifications that are detectable by mammography. In most cases, radiologists are able to distinguish calcifications usually associated with benign diseases from those associated with malignancy. In addition to their value in the early detection of breast carcinoma and accurate radiological diagnosis, the presence of microcalcifications often affects the extent of surgical intervention. Certain types of microcalcifications are associated with negative genetic and molecular characteristics of the tumor and unfavorable prognosis.
Personal information and conflict of interest
G. T. Boudour:
Nothing to disclose
F. ABIDI:
Nothing to disclose
A. Belkhir:
Nothing to disclose
S. Jelassi:
Nothing to disclose
k. thabti:
Nothing to disclose
z. skhouri:
Nothing to disclose
S. Essghaier:
Nothing to disclose
A. Zidi:
Nothing to disclose
References
Arancibia P, Taub T, de Grazia J, Díaz M, López A, Sáez C, et al. Microcalcificacionesmamarias: revisión de los descriptores y categorías BI-RADS. RevChilObstetGinecol 2013; 78: 383
Alsheh Ali M, Czene K, Hall P, Humphreys K. Association of Microcalcification Clusters with Short-term Invasive Breast Cancer Risk and Breast Cancer Risk Factors. Sci Rep. 10 oct 2019;9(1):14604.
Purdie CA, McLean D. Benign microcalcification and its differential diagnosis in breast screening. Diagn Histopathol. 1 août 2009;15(8):382‑94.
Kong J, Liu X, Zhang X, Zou Y. The predictive value...