Benign microcalcification (1)
This section along with benign microcalcification (2) and benign microcalcification (3) pulls together many of the more common benign causes of breast
microcalcification. These are new examples of the conditions in question - more
can be found on the relevant 'benign' pages elsewhere on the site and cross-links
are given frequently.
Sclerosing adenosis
- Very commonly accompanied by microcalcification
- Calcs usually numerous, fine textured and located within sclerosed acinar lumens
Sclerosing adenosis
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Sclerosing adenosis - Mammograms
(CC view, left; oblique view, right)
Courtesy of Jim Walsh & Pat Forrest
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Sclerosing adenosis - cropped view of above mammogram
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Sclerosing adenosis
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Apocrine metaplasia
- Less commonly accompanied by microcalcification
- When seen the calcs are usually coarse and luminal
- Phosphate and oxalate calcs may be seen - sometimes in the same case
Phosphate microcalcs:
Apocrine metaplasia - specimen x ray of core biopsy (substantially magnified)
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Apocrine metaplasia - phosphate microcalcs (arrows)
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Apocrine metaplasia in a core biopsy (low power) - phosphate microcalcs - Example 2
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Apocrine metaplasia - phosphate microcalcs (high power) - Example 2
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Oxalate microcalcs:
Differences between phosphate and oxalate calcs in the breast
(after Carter)
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Phosphate |
Oxalate |
| White light |
Yes |
No |
| Polarised |
No |
Yes |
| Benign |
Yes |
Yes |
| Malignant |
Yes |
? No |
| Ducts |
Yes |
Yes |
| Stroma |
Yes |
No |
Apocrine metaplasia - oxalate microcalcs (example 1) - more difficult to see in this medium power view than in the low power view (below, left)
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Apocrine metaplasia and oxalate calcs (example 1)
(low power - left & polarised light - right)
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Apocrine metaplasia - oxalate microcalcs (example 2)
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Apocrine metaplasia and oxalate calcs (example 2) (low power - left & polarised right)
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Apocrine metaplasia - oxalate microcalcs (example 3) - specimen x ray
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Apocrine metaplasia and oxalate calcs (example 3)
High power left & polarised light right
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Apocrine metaplasia & oxalate calcs (example 4). 'Mouse over' to see the polarised image.
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Columnar cell change
- Frequently accompanied by microcalcification
- Calcs often fine - may be luminal, intra-epithelial or in adjacent stroma
- Oxalate calcs uncommon
Columnar cell change with intra-epithelial calc
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Columnar cell change with granular microcalcification in a fibro-vascular core
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Columnar cell change with intra-epithelial (left - arrows) and periductal (right) calcs
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Columnar cell change with single fine luminal calc
Radial scars and complex sclerosing lesions
- Typically, these lesions are identified as 'distortions of architecture'/'stellate lesions' on mammograms
- If calcs are seen, which is not uncommon, they are an added extra rather than the main imaging diagnostic feature
- Calcs are normally luminal, fine textured and associated with the various pathological processes seen as part of these lesions e.g.
- sclerosing adenosis within the lesion
- columnar cell change
- usual type epithelial hyperplasia
Mammogram with radial scar (left - white arrow) and calcs (cropped right - red arrows) - Courtesy of Jim Walsh and Pat Forrest
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Radial scar
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Radial scar and luminal calc (blue box) in area of usual hyperplasia
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Radial scar and luminal calc (arrow) in area of usual hyperplasia from image above
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