The incidence of breast cancer is increasing, and the age of onset is becoming younger. In annual routine physical examinations, breast ultrasound or mammography is one of the essential check-ups for women. If the results of these examinations describe the presence of breast calcifications, does that mean it's breast cancer? Are breast calcifications scary? Breast calcifications are caused by various factors leading to the degeneration and necrosis of breast tissue or the accumulation of calcium salts, resulting in the calcification of breast blood vessels and surrounding tissues. Calcified lesions indicate degenerative changes in the internal breast tissue and glands, which may be related to previous local injuries, inflammation, and aging of breast arteries, and are usually not associated with cancer. Residues left by rapidly decomposing cells can appear as microcalcifications, forming microcalcification spots. When they appear in large clusters, they may indicate the presence of a small tumor. Therefore, not all breast calcifications are breast cancer; there are both harmless and concerning calcifications.
There are many types of benign breast calcifications, and X-ray results may show different forms such as dots, circles, double tracks, and columns. Benign calcifications have high density, varying particle sizes and shapes, mostly mixed and loosely distributed. Malignant calcifications commonly appear in three forms: small rod-like, sandy, and clustered calcifications. Among these, small rod-like calcifications are of significant diagnostic value for breast cancer, as areas with such calcifications often show cancer infiltration and a large number of cancer cells within the ducts. Sandy calcifications mostly occur in the acini at the periphery of the tumor, with microscopic findings of comedone-like secretions, widely distributed, numerous, and with fine, uniform particles. Although not calcifications at the tumor site, they are closely related to tumor development. Clustered calcifications have larger particles and irregular shapes, and their occurrence in necrotic tumor areas has high diagnostic value. The gold standard for determining whether it is breast cancer is still a biopsy. Pathological examination results, mammography, or ultrasound can only provide preliminary judgments. If there are suspicious calcifications, it is best to perform a biopsy of the lesion under ultrasound guidance to further confirm the nature of the disease, enabling early detection, diagnosis, and treatment.
