Approach to Calcifications

Breast calcifications are seen frequently in day-to-day practice on mammogram. Their frequency increases with age of the patient. Calcifications can be seen within a lesion or present as an isolated finding with no clinically palpable lump. Calcium deposition occurs within ducts, acini, stroma, or vessels in the form of calcium oxalate and calcium phosphate. Calcium oxalate is mostly seen in benign conditions and calcium phosphate is more commonly associated with malignant etiology. Calcium phosphate is more easily recognized on histopathology than calcium oxalate. X-ray mammogram remains the gold standard in detecting calcification till date. Ultrasound detects larger calcifications; however, it does not help in characterization of morphology. BI-RADS fifth edition classifies calcification according to morphology and distribution. These two categories are subdivided into benign and malignant according to the descriptors.