Does size matter? A review of screen-detected microcalcifications seen at breast screening assessment

A retrospective review was performed of 282 patients who were recalled to the breast screening assessment clinic for further evaluation of microcalcification over a 12-month period from 1 April 2005 to 31 March 2006.

Patients were subdivided into one of four groups according to the size of the calcification cluster and the pathology was reviewed to investigate the likelihood of diagnosing malignancy, either in situ or invasive, with differing extents of radiological abnormality.

Further mammographic views were performed in all cases and stereotactic core biopsy in 252 cases (89%). Thirty-one patients were felt to either not be suitable for or not to need biopsy after further mammography and were subsequently placed on early clinic review or routine recall. Where the biopsy failed to obtain calcification, the options of mammotome or early review were considered at the multidisciplinary team meeting. A summary of the findings is presented in Table 1.

Table 1

Small calcification clusters were often malignant (12.5% <5 mm) and included cases of invasive disease in 4.6%. They present a diagnostic challenge in detection and management, but may represent small invasive tumours.