What’s going on with grade 2 breast calcification?

Is breast calcification really scary? What should you do once breast calcification is detected?

Most breast calcifications are benign

Currently, commonly used breast imaging examinations include mammography and ultrasound. Mammography, commonly known as mammography, can detect early-stage breast cancer, including breast cancer that is negative to palpation (no lumps can be felt). Mammography is currently the most sensitive technique for detecting breast calcification. Breast calcification appears as high-density shadows on mammography, appearing as small white dot-like changes.

Breast calcifications can be divided into coarse calcifications and microcalcifications according to their size. They can be divided into punctate, amorphous, pleomorphic, short rod-shaped and branched according to their shapes. They can be divided into scattered, amorphous and branched according to their distribution. Diffuse, segmental and clustered distribution. Among them, coarse calcifications (including hollow calcifications) usually occur in benign lesions; scattered calcifications, whether coarse calcifications or microcalcifications, are benign calcifications; diffusely distributed microcalcifications without local clustering are usually benign lesions. Short rod-shaped and branched microcalcifications distributed segmentally and in clusters need to be considered as malignant. The risk of malignancy is above 90%, and they are mostly ductal carcinoma in situ or invasive ductal carcinoma.

Once breast calcification is detected during physical examination, everyone needs to be aware of the following points:

1. Most of the breast calcifications are benign.

2. Analysis of its properties requires a combination of size, shape, distribution, clinical history and other information.

3. Malignant calcification needs to be actively treated, while benign calcification and possible benign calcification can be followed up and reviewed.

In short, calcified lesions with different characteristics and properties on mammography need to be treated differently. After getting the diagnosis report, you must analyze it carefully with the doctor, take it seriously, and make treatment according to the specific situation. Don’t be overly nervous. .

It is difficult to perform a qualitative MRI

Some subjects were recommended by doctors to undergo further magnetic resonance imaging (MRI) examinations after discovering suspicious signs. MRI examination has high soft tissue resolution, and breast MRI examination has extremely high sensitivity in detecting breast lesions, with a high negative predictive value, close to 100%. Currently, breast MRI is mainly used in the following aspects: early detection and early diagnosis of breast cancer; differential diagnosis of breast lesions, mainly those that are difficult to characterize by mammography and ultrasound; negative or negative results in mammography and ultrasound benign, but clinically highly suspected to be malignant; preoperative local staging assessment of breast tumors, including tumor size, boundary, axillary and internal mammary lymph node status, etc.; evaluation of efficacy after neoadjuvant treatment for breast cancer; search for occult breast cancer, For example, if axillary lymph node metastasis is first discovered, the breast will be checked for breast cancer; follow-up after breast prosthesis implantation; and guided biopsy of breast lesions.

MRI examination is an imaging technology without ionizing radiation and is very safe. Of course, MRI is performed in a high magnetic field environment. Therefore, patients cannot have magnetic metal implants in their bodies. It is best to change clothes when entering the machine room to prevent coins and other metal objects from being sucked into the MRI machine, causing equipment failure and injury to the subject. Pacemaker implantation is an absolute contraindication for MRI examination. With the development of science and technology, some metal implants are now MRI-compatible and can enter the MRI machine room and undergo MRI examination.

Some patients require biopsy

A large part of breast calcification found during physical examination is negative by palpation. Palpation-negative breast lesions refer to lesions found on breast imaging examinations that are negative on clinical palpation and physical examination, some of which are early-stage breast cancer. Since breast abnormalities are only shown on images, preoperative diagnosis can only rely on imaging examinations, and imaging guidance is still required during surgery. At present, for lesions with negative palpation of the breast, the clinical treatment principle is: biopsy of the breast lesion under imaging localization, and the specimens are removed for pathological examination. After obtaining the pathological diagnosis results, the clinician performs processing according to the results; under the guidance of imaging technology, positioning hook wires are placed to guide the surgeon to remove the suspicious lesions, and the removed specimens are examined by mammography to confirm whether the suspicious calcifications, etc. be removed.

BI-RADS classification shows good and evil

The classification of BI-RADS often appears in the report conclusions of breast imaging examinations, and patients do not know much about it. In fact, the BI-RADS classification is the acronym for the American College of Radiology’s Breast Imaging Reporting and Data System. BI-RADS classification*** is divided into 7 categories "0-6":

(1) BI-RADS category 0: The current imaging data are insufficient to make a diagnosis and further examination is required;

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(2) BI-RADS Category 1: Negative;

(3) BI-RADS Category 2: Benign;

(4) BI-RADS Category 3: Possibly benign, the risk of malignancy is >0 but ≤2%;

(5) BI-RADS category 4: suspected malignancy;

(6) BI-RADS category 5, malignancy is likely , malignant risk ≥95%;

(7) BI-RADS category 6: malignant lesions confirmed by biopsy.

For specific breast lesions, different imaging technologies will have different BI-RADS classifications, and the technology with the highest sensitivity and specificity must prevail. For example, for calcified lesions, mammography should be used as the classification. Ultrasound and MRI are better for cystic lesions, especially small cystic lesions including intracystic papillomas. MRI is the most sensitive for detecting suspicious non-mass-like lesions in dense breasts.