Breast Calcifications

What are breast calcifications?

Breast calcifications are calcium deposits that commonly develop in breast tissue. They’re painless and too tiny to feel with your fingers, so you likely won’t know you have them unless they appear on a mammogram. A mammogram is a low-dose X-ray that detects atypical growths in breast tissue.

While calcifications are usually harmless, they can be an early sign of abnormal cells developing in your breast tissue. The size, shape and distribution of the calcifications may provide clues as to whether they’re a marker of a benign (noncancerous) condition or if more testing is needed to rule out malignancy (cancer).

What are the different types of breast calcifications?

There are two types of breast calcifications. They appear differently on a mammogram.

• Macrocalcifications appear as large white spots randomly scattered throughout your breasts. They’re the most common type of calcification found in breast tissue. Macrocalcifications are typically benign and usually don’t need follow-up imaging.
• Microcalcifications appear as small white spots. The spots may be randomly scattered, or they may appear in groups or as specks in a line. Microcalcifications are also usually benign, but they’re more likely to signify cancer than macrocalcifications. If your provider sees this on your mammogram, they may order more testing to check for precancerous cells or cancer.

How common are breast calcifications?

Breast calcifications are very common, especially if you’re over 50. About half of people assigned female at birth get benign breast calcifications.

What are the symptoms of breast calcification?

Breast calcifications often don’t cause symptoms, and they’re too small to feel during a breast exam. Instead, you’ll likely learn that you have them during a routine mammogram.

What causes breast calcifications?

Researchers don’t know what causes calcifications, but several possible explanations exist. Calcium deposits form in response to various processes affecting your breast tissue. Benign breast calcifications are associated with:

• Breast injury.
• Breast cysts.
• Breast infections.
• Aging arteries in your breast.
• Benign breast lumps (fibroadenomas).
• Mammary duct ectasia.
• Previous breast surgery.
• Previous breast cancer treatment.

Cancerous breast calcifications are often related to ductal carcinoma in situ (DCIS). DCIS is a non-invasive form of breast cancer that forms in your milk ducts. Non-invasive means that cancer hasn’t spread beyond your milk ducts.

What doesn’t cause breast calcifications?

The name can be confusing, but you can’t get breast calcifications by having too much calcium in your diet or taking too many calcium supplements.

How are breast calcifications diagnosed?

Most breast calcifications are benign and don’t require any special follow up. There is overlap, though, between the commonly benign calcifications and calcifications that could be an indication of something abnormal. In other words, they can often look the same on your mammogram. For instance, if the mammogram shows a tight cluster of calcifications or tiny flecks of white in a line, the radiologist (the specialist who analyzes the X-ray) may recommend additional testing to rule out cancer.

Follow-up tests may include:

• Diagnostic mammogram: This is a more detailed mammogram than one that’s done for routine screening. Pictures of the affected part of your breast may be taken from many angles to give the radiologist a closer look. This is typically the first test a provider orders to learn more about breast calcifications. Magnification views of the calcifications are an important part of the workup and give the radiologist a better look at their shape and arrangement.
• Biopsy: In many cases, a biopsy is needed to determine the underlying cause of calcium deposits. The biopsy procedure is minimally invasive and involves using imaging to remove a small amount of breast tissue so that a pathologist can check it for signs of disease. During the test, your provider will use mammogram images to guide the biopsy, which is called a stereotactic biopsy of the breast. Tiny pieces of breast tissue in the area of the calcifications are removed in order to assess the area (core needle biopsy).

Can a mammogram be incorrect in identifying breast calcifications?

Sometimes noncancerous lumps or cysts can be associated with calcifications on a mammogram. So can powders, creams or deodorants applied on the skin near your breasts. This is why you shouldn’t wear deodorant to a mammogram. If you forget, be sure to wipe it off before the test begins.

How are breast calcifications treated?

Most causes of breast calcification are benign (not cancerous) and don’t require treatment. The radiologist who reviews your X-rays for future mammograms can compare new images to previous ones and see if the calcifications have changed.

If one or more follow-up tests indicate that the calcifications are abnormal or may be signs of cancer, you may need to see a doctor who specializes in breast diseases. Most commonly, this is a breast surgeon. Treatment options may include:

• Monitoring the tissue for any concerning changes.
• Removing the breast tissue or the entire breast.
• Chemotherapy and/or radiation.
• Targeted drug therapy.

Discuss your results and treatment options with your healthcare provider.

Do breast calcifications need to be removed?

Not usually. Calcium deposits form when cells divide and grow. They’re harmless on their own. The only time to be concerned is if the calcifications result from cells growing and dividing abnormally, as with precancerous cells or cancer. Even then, the cancer cells — not the calcifications — would need to be removed.

How can I prevent breast calcifications?

You can’t prevent breast calcifications, but early detection through a mammogram is important in identifying any possible cancer that could develop.

Can breast calcifications turn into cancer?

Microcalcifications are sometimes — not always — a sign of cancer in your breasts. But usually, calcifications are a sign of a benign condition.

The good news is that once a mammogram detects calcifications, they become part of your medical record. The radiologist who reviews future X-rays can note any differences that may indicate precancerous changes so that you can receive further testing and treatment as needed. Early detection can prevent breast cancer.

What percentage of breast calcifications are cancerous?

According to one study, suspicious calcifications that require follow-up testing turn out to be cancer approximately 12% to 40% of the time. Other research suggests that many of these cases are likely false positives, where a possible or questioned cancer diagnosis turns out to be benign. Research is ongoing to improve cancer detection technologies so that misdiagnosis doesn’t happen.

Routine mammograms are essential for detecting cancer early. Microcalcifications are present in approximately half of breast cancer cases with no detectible lump. Mammography screening that detects microcalcifications aids in diagnosing 85% to 95% of DCIS, or the early cancer cells that are contained within the milk ducts.

Should I worry about calcifications in my breast?

Calcifications are usually benign and not cause for concern. In the rare instance when they may be a marker for cancer, your provider can intervene as needed to get you closer to a diagnosis and the early-stage treatment you need.

What do I need to do if breast calcifications are found during a future mammogram?

Continue getting routine mammograms and discuss any concerns about breast calcifications with your provider. Generally, if you’re at average risk of breast cancer, you should begin routine screenings for breast cancer every one or two years, starting at age 40.

If your calcifications are potentially cancer-related, you may need additional imaging procedures or more frequent mammograms. Follow your provider’s guidance on the most appropriate mammogram follow-up for you.

What questions should I ask my doctor?

• What are the potential causes of my calcifications?
• Should I be concerned that the calcifications may be signs of cancer?
• What follow-up testing (if any) would you recommend for me?
• Will having breast calcifications affect how often I should get a mammogram?
• How will records of my calcifications be stored so that future X-rays can be compared to previous ones?

A note from Cleveland Clinic

Even a slight chance that calcifications may be a marker for cancer can cause some people to assume the worst. But try not to jump to conclusions if your provider finds calcifications on a mammogram. Many benign conditions can leave behind calcium deposits in your breast tissue. These traces aren't likely a sign of malignancy. If cancer is found to be the cause, discuss your prognosis with your provider. There may be treatments available that can prevent your cancer from progressing or that can cure it completely.