Dr Shashta Sawh
Breast physician
Pink Hibiscus Breast Health Specialist
For many doctors working in breast clinics, breast calcifications is a very common topic which should be discussed with patients.Many patients undergoing a routine screening mammogram may discover white specks in either one or both breasts on a mammogram. But what exactly are these white spots?
Calcifications or calcium deposits in the breast tissue appear as white spots on a mammogram.
In most instances these are usually benign and non-cancerous. They are very common in the post-menopausal group of women with as much as 50 per cent having these, and a smaller percentage of approximately ten per cent in pre-menopausal women. But why do these calcium deposit in the breast tissue?
For the majority of times, calcifications represent an innocent finding. This may occur for a variety of benign reasons, as a result of normal ageing, inflammation, past trauma to the breast, fibroadenoma (benign breast lump), duct ectasia (dilated ducts).
In a smaller number of women, however, calcifications can represent a pre-cancerous condition called DCIS (ductal carcinoma in situ) and early breast cancer. A specialist breast radiologist can determine from mammogram images whether calcifications appear benign or suspicious based on shape and pattern.
Benign calcifications can be left alone, not warranting any further investigation, and annual screening is all that's usually needed.
However, if after careful review by a doctor at a specialist breast clinic a patient's breast calcium appears suspicious or indeterminate then a biopsy (sampling of the breast tissue) would be necessary.
With the advancement in technology, sampling of calcium from a breast can be performed under image guidance and through a needle hole instead of the old fashioned way of a minor surgery simply for obtaining a piece of tissue for testing.
Patients can undergo such a procedure using a vacuum machine which allows this biopsy to be done by the least-minimally invasive way possible.
This involves local anaesthetic versus general anaesthesia as in a surgery. It does not involve a scar and patients are well to resume normal duties after. Once this sample of breast tissue is obtained it is then sent off to the laboratory for testing.
Because breast calcifications can either be benign or abnormal, it is recommended that any substances used on the skin which can mimic calcifications on a mammogram be avoided. And it is for this reason body creams, lotions, powders and deodorants should not be used prior to a mammogram.
So having your annual mammograms from the age of 40 is important to detect abnormal changes of the breast at its earliest stages. Missing a breast screening can potentially lead to a missed diagnosis of DCIS or early breast cancer, which if found can be managed appropriately at specialised breast clinics.