"dystrophic" breast calcifications

 

Dystrophic calcification is a name given to a certain kind of breast calcification that is commonly found on a mammogram. It is considered a benign finding. However, the most common situation in which one finds dystrophic calcifications is following breast cancer radiation treatments. These are calcifications which would show up on a followup investigation, and are generally a welcome sign. They are also quite common following breast trauma, including surgery.

 

dystrophic calcification of the breast

 

Most breast calcifications are caused by benign breast changes

Breast calcifications are routinely found on breast cancer screening mammograms. They are generally formed from deposits of calcium salts in degerated or necrotic (dead) breast tissue. Calcifications are an important sign of changes in the breast, most of which are benign, some of which are more worrisome. Calcifications and microcalcifications (smaller, and usually discovered 'earlier') are part of a breast cancer risk classification system called "BI-RADS", which classifies calcification based on various characteristics. A "Dystrophic" calcification is one such classification, which roughly corresponds to a BI-RADS category of "2", which is a benign founding, not indicative of cancer in any way.

Characteristics of dystrophic breast calcifications

Dystrophic calcifications tend to be on the large side (greater than 0.5mm), irregular in shape, and course. They also tend to be quite dense, and have lucent (shining/glossy) centers when viewed microscopically. Dystrophic calcifications also tend to have smooth margins, unlike the irregular margins common in microcalcification suggestive of malignancy.

 

dystrophic breast calcifications

 

What does a finding of 'dystrophic calcifications' really mean?

If dystrophic breast calcifications have been found on a screening mammogram, it most likely indicates some other benign condition besides cancer. For women who have already had treatments for breast cancer, dystrophic breast calcifications are to be expected, and suggest that everything is OK.

dystrophic calcifications in breast tissue often remain stable for many years

Large dystrophic breast calcifications usually remain stable for many years, and are typically not associated with any kind of palpable mass. Following a breast procedure, up to 30% of women may develop dystrophic breast calcifications for up to 4 years.

breast dystrophic calcifications can return after radiation treatments

But, If dystrophic calcifications return following breast reduction surgery or radiatation therapy in a new position, this is a bit more of a concern. The BI-RADS (breast cancer risk) category may be elevated to 3 or 4. ( 'probably benign' to 'somewhat suspicious for malignancy')

Other possible causes of dystrophic calcification in breast tissue

Benign dystrophic breast calcifications may also be caused by paraffin or silicon injections from breast augmentation procedures, or may occur with dermatomyositis or as a secondary effect of hyperparathyroidism.

 

References

  1. Meier-Meitinger M, Adamietz B, Schulz-Wendtland R. Ehlers-Danlos syndrome and bilateral, dystrophic breast calcifications. Radiologe. 2009 Sep;49(9):868-71.
  2. Jackson, VP. Diagnostic Mammography. Radiol Clin North Am. 2004 Sep;42(5):853-70, vi.
  3. Picca, D., de Parades, E.S., Calcifications in the breast: A radiologic perspective. Applied Radiology, Volume 32, Number 9, September 2003
  4. Sickles EA (1986) Breast Calcifications: Mammographic Evaluation Radiology; 160:289-293
  5. Yi, A., Kim, HH., Shin, HJ., Huh, MO., Ahn, SD., Seo, BK. Radiation-Induced Complications after Breast Cancer Radiation Therapy: a Pictorial Review of Multimodality Imaging Findings. Korean J Radiol. 2009 Sep-Oct;10(5):496-507.

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Copyright Steven B. Halls, MD Last edited 21-August-2011

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