Can breast calcifications disappear?

Breast calcification

1. Discovery of breast calcification

With the increasing maturity of high-definition and high-frequency mammography and ultrasound technology, the need for The more asymptomatic women with no clinically palpable lumps, women with various symptoms and high-risk groups for breast cancer, in addition to various manifestations of breast disease found during the examination, about 2/3 of them may have calcifications in the breasts. film.

2. The manifestation of calcification occurring in cancer cells:

It often occurs in degenerated and necrotic areas of cancer cells, manifesting as piles of sand-like calcifications, and sand-like calcifications can be seen at the edge of the mass. This is because calcification after tumor cell necrosis occurs in necrotic debris at the edge of the infiltrative mass. Therefore, calcification around the lesion also has clinical significance. No mass was seen, but clusters of fine calcifications were seen, and irregular calcifications appeared in the calcification groups, which could be considered to have malignant diagnostic value. Combined with clinical practice, for example, the display of increased microcalcifications in the breast has certain significance for early detection of breast cancer.

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

The calcification particles are small, with a diameter of 10 to 500 μm, generally no more than 1000 μm. On X-ray films, the visibility to the naked eye is approximately 150 μm. Mammograms with dense breasts or poor background often require the use of a magnifying glass to identify calcifications.

With the improvement of the performance of ultrasonic instruments and the application of high-frequency probes, ultrasonic technology can be used to observe microcalcifications. Ultrasound can detect beads as small as 110 μm in a hypoechoic background that simulates breast cancer, while the smallest beads detected by radiography are 200 μm. The detection rates of microcalcifications in breast cancer by high-frequency ultrasound and X-ray photography were 56% and 35% respectively. However, there are also reports that B-ultrasound and MRI are difficult to detect microcalcifications due to their limitations.

The value of breast calcification in the diagnosis of breast cancer

1. Incidence of breast cancer calcification:

Calcification is one of the common imaging manifestations of breast cancer . Certain specific forms of calcification are risk factors for breast cancer. Statistics show that 65% of breast cancers have calcification, of which 70% are malignant calcifications.

2. The only X-ray sign of early breast cancer

Clustered microcalcifications are often the only X-ray sign of early breast cancer. The nature and extent of the disease can be reflected according to the shape, size, number and density of microcalcifications. Microcalcifications can be located in or around the mass, with a total number of 6 to 15, uneven density, and varying sizes.

Mammography can improve the diagnosis rate of occult cancer, microcarcinoma (less than 10mm in diameter) and early cancer. It is difficult to characterize masses with a diameter less than 10 mm, but fine sand-type calcification is often an alarm for malignant lesions; if signs such as surrounding structural disorder, bilateral asymmetry, and thickening of blood vessel shadows are present at the same time, malignant lesions are more likely.

3. Formation of microcalcifications in malignant breast lesions

Malignant breast lesions have a large number of microcalcifications per unit area, which may be due to various reasons such as cancer tissue necrosis and cancer cell secretion*** Caused by the same effect. The different densities and sizes between calcification points may be due to the different lengths of calcium salt deposition. As time goes by, the first calcifications formed have a relatively high density and a relatively large volume.

4. Differences between benign and malignant calcifications

Compared with benign calcifications, the average density of malignant calcification groups is lower, and density and size are of great value in distinguishing benign and malignant breast diseases. The distribution of microcalcifications in mammograms seems to be irregular, but when pathological pathology reveals that cancer occurs in the terminal ducts, the calcifications can be located in large necrotic tissues or between cancer cells, or in the upper ducts or duct bifurcations. or within the lumen of adjacent acini.

5. The formation of calcification in the cancer focus area

The regional calcification in the cancer focus can be fine sand type or mixed type.

The calcification in the duct is worm type. It may be related to the abnormal secretion of tumors draining along the ducts.

When the cancer is located in a larger duct, calcification far away from the lesion is often located in the peripheral lower-level duct, mainly in the form of fine sand. This may be abnormal metabolites of cancer cells or backflow of cancer cells stimulating the peripheral ducts and Produced by acini. A large number, fine particles, and rough edges, which can be located inside or outside the mass, indicate malignancy.