Question from: 4/20/98

What are breast calcifications? Can they be caused by a needle being inserted into a breast lump to withdraw fluid? Can calcifications signal a breast lump malignancy? Should calcifications be treated or surgically removed?

I am scheduled to go in for a needle biopsy and I don't think it is really necessary. I have no history of breast cancer in my family and I do have breast fibroids. The calcifications showed up in a breast that had a needle inserted to drain fluid from a lump in 1994.

by G. Steven Webb, M.D.

General Surgery Group, P.A.

Answer: Breast calcifications represent areas in the breast tissue where calcium has been deposited--usually as a result of benign processes. It is possible, but highly unlikely, that they would result from a needle cyst aspiration or even from a needle-core biopsy.

80% of the time, a cluster of microcalcifications represent benign processes such as fibrocystic disease (particularly a variant of fibrocystic disease called sclerosing adenosis).

Microcalcifications can represent an early malignant change; however, and if the radiologist is suspicious of the microcalcifications, then a biopsy may be warranted. A biopsy may be able to be obtained by stereotactic core needle biopsy (per the radiologist) or by an open surgical biopsy in the operating room. If the microcalcifications cannot be felt (palpated) then the radiologist may need to place a hook wire preoperatively to guide the surgeon if he is doing an open surgical biopsy.

It would not be unusual for microcalcifications to have developed in an area in which a cyst had been found previously, since continued inflammation due to the fibrocystic disease in the area may later cause calcium deposition.

Even though there is no family history of breast cancer, the possibility of development of a breast cancer is still 11% (1 in 9) over the course of your lifetime. Although the odds are that you will never develop a breast cancer (1 in 9), and that these microcalcifications are benign (4 out of 5), a diagnosis should still be sought aggressively. In the cases where microcalcifications are a signal of an early malignant change, they allow us to diagnose and to treat breast cancers in their earliest stages and to ultimately save lives.

G. Steven Webb, M.D.

General Surgery Group, P.A.


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