Order Breast Micro-calcifications Questions

Order Breast Micro-calcifications Questions
Q: What are microcalcifications?
A: Microcalcifications are a form of dystrophic calcification caused by the movement of calcium into the cell. Calcium
appears to move into the cell when the cell is damaged or dies. Calcium is radiopaque and may be seen on imaging.
Microcalcifications can occur alone or in combination with a tumor. They can also occur for reasons that we do not
fully understand.
Q: What types of mammography services are available?
A: Mammography is an X-ray of the breast that can detect abnormalities, including microcalcifications and tumors.
It’s used for both screening and diagnosis. Several different types of mammography services are available nationwide
and include screen film mammography, computer-assisted film mammography and digital mammography. One
study indicated that computer assistance improves detection rates slightly, but increases recall rates (Fenton et al.,
2007). Digital mammography (another computer methodology) has not shown statistically significant differences in
increased cancer detection, and impact on recall rates was unclear (Elmore et al., 2005)
Q: Could mammography screening have negative effects?
A: Mammography findings may be inconclusive or inaccurate. There is substantial concern about the proportion of
false-positive results, which are when the mammogram shows an abnormality when there actually is none. Women
who have false-positive results often undergo additional medical testing and procedures such a breast biopsy. While
breast biopsies are rather uncomplicated surgical procedures, they do subject the patient to discomfort, anxiety and
additional costs. Approximately 33 percent of breast cancers detected by screening mammograms may represent
overdiagnoses.
Q: What is the relationship between DCIS and microcalcifications?
A: As a cancer tumor begins at the earliest cellular stages, the surrounding cells may be damaged and take on ad-
ditional calcium. Therefore, these calcifications are often found in areas around tumors as well as alone. When they
occur alone, it’s presumed that they might represent the beginning of a cancer tumor.
Q: What types of microcalcifications are seen?
A: Microcalcifications occur in varying sizes and clusters with irregular and asymmetric densities. These configura-
tions may include branching, coarse and fine granular types. If they occur along the milk ducts, they tend to be
branching. The appearance of the microcalcifications is important because some types are more commonly associated
with more aggressive types of breast cancer.
Q: What percentage of patients with microcalcification(s) has DCIS or invasive cancer?
A: Between 15 and 30 percent of lesions detected through mammography are diagnosed as DCIS and occur as micro-
calcifications alone. At this point, it’s not known whether discovering a breast cancer earlier actually saves lives. Some
women’s DCIS may be preinvasive or low-grade invasive cancers that do not require additional surgical or medical
therapy.
Q: Which women should definitely have screening mammography?
A: Women at higher than average risk should seek out a health care provider particularly knowledgeable about breast
cancer risk and cancer genetics for specialized guidance about screening and recommended intervals. Women who
have a positive family history of breast cancer or are experiencing symptoms of disease (lump, pain, discharge and/or
change in breast contour) should be actively encouraged to have mammography screening.