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Breast calcifications

This page was reviewed under our medical and editorial policy by

Daniel Liu, MD, Plastic and Reconstructive Surgeon, CTCA Chicago.

This page was reviewed on May 4, 2022.

Breast calcifications are calcium deposits that are found in breast tissue and are fairly common, especially in women older than 50. It’s important to understand these types of breast changes because they may be the earliest sign of certain conditions, such as ductal carcinoma in situ (DCIS) or invasive breast cancer.

Calcifications aren't connected to calcium from a diet or supplements. Calcium is a natural byproduct of breast cells growing and dividing.

What are the different types of breast calcifications?

The two types of breast calcifications are microcalcifications and macrocalcifications.

Microcalcifications: These tiny calcifications are the more concerning of the two types because they could be cancerous. If a doctor sees these on a mammogram, additional testing may be needed.

Macrocalcifications: In contrast, macrocalcifications are larger and coarser areas of calcium deposits. Common in women older than 50, these may be caused by a variety of factors.

What causes breast calcifications?

Most of the time, breast calcifications are benign—meaning they aren't cancerous. Sometimes, though, because of how these calcifications appear on images, the patient may need to undergo additional testing to rule out any concerns. Certain patterns of specific types of calcifications may point toward breast cancer. Causes vary depending on whether the calcifications are benign or malignant (cancerous).

Causes of benign calcifications

Benign, or noncancerous, calcifications can be caused by:

  • Advancing age
  • Past injury to your breast
  • Breast infection
  • Breast changes, such as fibroadenomas (small breast lumps) or cysts
  • Calcium deposits, such as calcium oxalate (a colorless crystal) that collects from normal cell processes

Causes of malignant calcifications

Malignant, or cancerous, breast calcifications can be caused by:

How are breast calcifications diagnosed?

Calcifications may appear as bright white spots on mammograms. You can't feel them from the outside, so the only way to detect them may be through a mammogram.

If your doctor finds areas of microcalcifications—the smaller ones—it doesn't mean you'll automatically need a breast biopsy. However, if the deposits look suspicious, are clustered together or appear in a line on the mammogram or under the microscope, your care team may order one to rule out any concerns.

With microcalcifications, your care team may also order a follow-up mammogram in six months to monitor the area. Doctors also may recommend a mammogram that includes spot compression, or cone compression—a technique that provides a closer look at a certain area of the breast. In order to get a clearer look and to push aside healthy breast tissue, doctors use a small compression plate to separate the tissues. This improved view may help your care team monitor how the calcium is growing, as well as the size and shape of the deposits.

If you have macrocalcifications, your care team may be able to diagnose them without a biopsy, because they may appear as larger white spots on mammograms.

Can breast calcifications be a sign of cancer?

Microcalcifications in a certain pattern may signal cancer, because when breast cells are growing and dividing, they make more calcium. So, if there’s an area of the breast where this growth is occurring, the calcium deposits would be grouped together.

Sometimes, breast calcifications are the only sign of breast cancer, according to a 2017 study in Breast Cancer Research and Treatment. The study notes that calcifications are the only sign of breast cancer in 12.7 to 41.2 percent of women who undergo further testing after their mammogram. Researchers found that 54.5 percent of calcifications that are associated with cancer could have been potentially diagnosed earlier.

On the other hand, a 2019 study in the journal Radiology notes that a false-positive result for calcification biopsies isn’t uncommon—30 to 87 percent of women who had their calcifications biopsied underwent the invasive procedure and didn’t have breast cancer. This study found another predictor for calcifications linked to cancer: DCIS calcifications grow at a faster rate than benign calcifications.

This highlights the importance of improving technology to be able to distinguish the calcifications that may be linked to cancer vs. those that are benign.

While it’s important to know that breast calcifications are oftentimes not related to cancer, it's also a good practice to have them monitored, especially if you’re more at risk for cancer in general or have undergone treatment for breast cancer in the past.

If you have microcalcifications, your doctor may order a second mammogram or a biopsy, or may wait to order another mammogram after six months.

Breast calcification biopsy

If your breast calcifications seem suspicious, a test called a biopsy can identify the makeup of their cells. The most common type of breast biopsy is a core needle biopsy. During a core needle biopsy, your doctor inserts a hollow needle into your breast to remove samples of tissue from the suspicious area.

For the test, you’ll lie flat on your back on the examination table and place your right arm over your head if your right breast is being biopsied, or raise your left arm if your left breast is being biopsied. Your breast will be numbed so you should have minimal, if any, discomfort.

Your doctor is likely to use ultrasound as a guide to identify where to insert the needle. In some cases, magnetic resonance imaging (MRI) may be used as a guide.

After the tissue sample is retrieved, it’s sent to a laboratory, where a pathologist examines the cells under a microscope to see whether they’re cancerous.

What's next?

If your care team finds evidence of breast cancer after a biopsy, they may diagnose and stage the disease. The recommended treatment plan may involve surgery, chemotherapy, radiation therapy, targeted therapies for breast cancer or a combination of these.

Keep your care team informed of any breast changes you notice, and continue to schedule routine mammograms as recommended for your age.

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