Breast calcification

Breast calcification is the formation of calcium deposits in the breast, which can be diagnosed through mammography. Breast calcification can be divided into large calcification and small calcification. Large calcification is formed by the hardening and accumulation of tissue in the breast and generally needs to be distinguished from tumors. Microcalcifications are small dead cells scattered throughout the breast that may become cancerous. Breast calcification is not painful, but regular check-ups are necessary and are important for the diagnosis of cancer.

1. Discovery of breast calcification

With the increasing maturity of high-definition mammography and high-frequency ultrasound technology, more and more women who have no clinically palpable lumps may have calcifications in their breasts in addition to various manifestations of breast diseases during examination.

2. Calcification in Cancer Cells

It often occurs in the degeneration and necrosis areas of cancer cells, manifesting as piles of sand-like calcifications, which can be seen at the edge of the tumor. This is because calcification after tumor cell necrosis occurs in the necrotic debris at the edge of the invasive mass. Therefore, calcification around the lesion also has clinical significance. No mass shadow is seen, but clusters of tiny calcifications are visible, and irregular calcifications appear in the calcification groups, which may be considered to have malignant diagnostic value. Combined with clinical practice, the addition of microcalcification foci in the breast is of certain significance for the early detection of breast cancer.

3. Characteristics of breast cancer calcification by high-frequency ultrasound and X-ray

The calcification particles are small, with a diameter of 10 to 500 μm, generally not exceeding 1000 μm. On X-ray films, the naked eye visibility is about 150μm. For breast mammography films with dense breasts or poor background, a magnifying glass is often required to identify calcification foci.

With the improvement of ultrasound instrument performance and the application of high-frequency probes, microcalcification can be observed using ultrasound technology. Ultrasound can detect beads as small as 110 μm against a hypoechoic background simulating breast cancer, while the smallest bead detected by mammography is 200 μm. The detection rates of microcalcification in breast cancer by high-frequency ultrasound and X-ray were 56% and 35%, respectively. However, there are also reports that B-ultrasound and MRI are difficult to detect microcalcifications due to their limitations.

4. Differences between benign and malignant calcifications

Compared with benign calcifications, the average density of malignant calcifications is lower, and their density and size are of greater value in distinguishing benign from malignant breast diseases. The distribution of tiny calcifications in breast X-rays seems to have no pattern to follow, but when pathology finds that the cancer occurs in the terminal duct, the calcification may be located in large areas of necrotic tissue or between cancer cells, or it may exist in the superior duct or at the bifurcation of the duct or in the adjacent alveolar cavity.