Skip to main content

Impact of full-field digital mammography on diagnostic work-up and surgical management of mammographic microcalcification


Full-field digital mammography (FFDM) increases detection of benign and malignant calcified breast lesions. Accurate nonoperative diagnosis of malignant impalpable breast lesions minimises numbers of therapeutic surgical procedures. Correct diagnosis of malignant mammographic microcalcification (MM) is important because upgraded lesions require repeat surgical procedures in 57% of cases (NHSBSP Audit 2012).


Screening and symptomatic women with MM (n = 1,479) were reviewed to determine the impact of FFDM (imaging with FFDM only since April 2010) on the positive predictive value (PPV), diagnostic accuracy and surgical management of MM. Demographic information, preoperative and postoperative diagnosis and number of surgical procedures were recorded for Group 1 (August 2007 to March 2010: n = 711) and Group 2 (April 2010 to May 2011: n = 768).


Reduction in PPV of biopsy for MM was observed (Group 1, 42.6%: Group 2, 32.7%; P < 0.0001). Correct or concordant nonoperative diagnosis increased with FFDM (Group 1, 89% vs. Group 2, 95%; P < 0.0001) and was achieved more often at first attempt (Group 1, 80.6% vs. Group 2, 89.5%; P < 0.0001). More lesions under 5 mm were biopsied using FFDM (Group 1, 15%; Group 2, 20.4%; P = 0.008). Accurate preoperative diagnosis of malignancy permitted single-stage surgery in 77.4% Group 2 versus 67.9% Group 1 (P = 0.017). For DCIS cases, similar first-line mastectomy rates were observed (Group 1, 30.3% vs. Group 2, 33.3%, P = NS). Fewer B3/4 lesions upgraded at surgery (Group 1, 48.7% vs. Group 2, 20%; P = 0.011).


Nonoperative work-up of MM using FFDM reduced second therapeutic procedures for MM, decreased upgrade of B3/4 lesions at diagnostic surgery, but increased benign nonoperative biopsies for MM.

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Bundred, S., Zhou, J., Whiteside, S. et al. Impact of full-field digital mammography on diagnostic work-up and surgical management of mammographic microcalcification. Breast Cancer Res 14 (Suppl 1), P20 (2012).

Download citation

  • Published:

  • DOI:


  • Positive Predictive Value
  • Breast Lesion
  • Therapeutic Procedure
  • Symptomatic Woman
  • Mastectomy Rate