Atlas of breast cancer early detection

Calcifications in the breast parenchyma can be categorized according to their distribution.

• Diffuse or scattered: Calcifications are scattered throughout the whole breast or multiple similar appearing clusters of calcifications are seen through the whole breast .
• Regional: Calcifications are in an area of breast tissue 2 cm across and do not correspond with the expected ductal distribution .
• Grouped or clustered: At least five calcifications are grouped together within 1 cm of each other or numerous calcifications are grouped together within 2 cm of each other. When clusters are scattered throughout the breast, it suggests a benign entity. A single cluster of calcification suggests a malignant entity .
• Linear: Calcifications are arrayed in a line, which suggests deposits in a duct. Linear distribution is typically seen when DCIS fills the entire duct and its branches with calcifications .
• Segmental: Calcium deposits are in ducts and its branches in a segment or lobe. It suggests a malignancy. Sometimes this differentiation can be made, but in other cases the differentiation between regional and segmental is problematic because it is not clear on a mammogram or MRI exactly where the boundaries of a segment (or a lobe) lie .

Diffuse or scattered calcifications in a large volume of the breast or throughout the breast are benign calcifications. It is unusual for breast cancer calcifications to have such extensive involvement. Stability of the calcifications on short-interval follow-up mammograms at 6 months for 2 years and then annually is a likely indicator of benign calcifications.