Breast calcifications are a common finding, they are found on approximately one-half of all mammograms in women age 50 and above. As these small calcium deposits are too small to be felt, they are often first detected as small, bright white spots on a mammogram. If these calcifications show up in certain patterns, such as growing in a cluster or line, they may be a sign of breast cancer.
Definition & Facts
Breast calcifications are defined as small spots of calcium salts that can be found anywhere in the breast tissue. As they are too small to be detected on a breast exam, and because they cause women no discomfort, they often go undetected until seen on a mammogram.
The main types of calcifications include micro and macro. Micro-calcifications are not only smaller, but they appear in larger numbers than macro-calcifications. They are typically benign, meaning non-cancerous in nature, however, they still may be a sign of breast cancer and require follow-up testing to verify they are in fact, non-cancerous.
Macro-calcifications are more round in shape and appear larger than micro-calcifications on a mammogram. These calcifications require no follow-up as they are almost always benign (non-cancerous).
Other causes for the development of breast calcifications include previous surgery or invasive injury to the breast, calcification of the breast's skin or blood vessels, the formation of fluid-filled sacs that are non-cancerous called breast cysts, a solid non-cancerous mass common in younger women known as a fibroadenoma, secretions or debris from cells within a woman's body, milk duct walls that are swollen and clogged related to thickening up of the duct wall and the filling of fluid within the duct, previous radiation therapy for cancer, and an infection in the tissue of the breast that commonly affects breast-feeding women, known as mastitis.
When to see a doctor
When a mammogram is performed it is reviewed by one or two radiologists who specialize in the use of medical imaging (mammograms) to diagnose and treat disease. Characteristics of interest to radiologists include the size, shape, and pattern of calcifications. Follow-up with a primary physician is guided by the classifications of the breast calcifications, which includes benign looking, uncertain, or suspicious of cancer.
Upon viewing a breast calcification on a mammogram, additional testing may be recommended by the radiologist if the cause of the calcifications is unclear or the image can't be viewed well. A primary physician will take the initiative and set up the appointments for a woman to have additional mammograms and further testing as well. These will typically include enhanced views of the breast which allow magnification of the calcifications, or possibly the removal of a sample of breast tissue called a biopsy.
The decision to seek further diagnostics and/or a biopsy are based on the recommendations of the radiologist. In addition, the concerned radiologist may request any previous images of a mammogram that a woman has had in the past to compare each view, allowing for the determination to be made whether or not the calcifications are new, or have changed in pattern or number. Six months after the discovery of calcifications on a mammogram, the radiologist may recommend that a woman undergo a follow-up mammogram to assess whether the calcifications remain stable or unchanged.
A woman's primary physician will advise her of the next steps if it is verified that the breast calcification is non-cancerous. However, if a woman is advised that the calcifications could potentially be an early sign of breast cancer, she will be referred to a surgeon and work with his/her team of professionals to receive necessary education and discuss future treatment options.
Treatment & Therapy
If a biopsy confirms that a women is affected by breast cancer, her team of specialists will begin to discuss treatment options and possible related side effects. Often, surgery is the first treatment for breast cancer. The goal of surgery is to remove the breast cancer along with a small border of normal breast tissue to decrease the risk of cancer recurring and to prevent the cancer from being spread to other areas within the body.
Chemotherapy is a type of cancer treatment that uses anti-cancer drugs to destroy breast cancer cells. Chemotherapy interrupts the way in which cancer cells grow, making it difficult for them to divide and grow. Often a combination of chemotherapy drugs will be used for treatment as they all work differently within the body and affect the harmful cancer cells during different phases of their growth.
Radiotherapy is a cancer treatment that uses high energy X-rays that are carefully controlled and measured. It is aimed at destroying any left behind cancer cells that may still be present after surgery. There are also a large variety of hormone therapies, each working in their own way. As the hormone estrogen can stimulate the growth of some breast cancers, these hormone therapies work by blocking the effects estrogen may have on cancer cells.
Additionally, targeted therapies consist of a combination of drugs that block the growth and spread of cancer cells. They work by targeting and interfering with the cells process that is necessary for cancer to grow. A well-known targeted therapy is trastuzumab. Other therapies of this nature include lapatinib, bevacizumab, everolimus, pertuzumab, and more.
Prevention & Prophylaxis
As these calcifications have the potential to be early signs of breast cancer, further reading will explore ways in which women can take charge of their health and prevent breast cancer. Some women who are past their childbearing and breastfeeding years opt to have a preventable double mastectomy if they are considered high risk. Proper nutrition plays a big role in the prevention of breast cancer, women are encouraged to eat their way to a healthy life with lean protein, moderate fats and complex carbohydrates.
Other ways to prevent breast cancer include drinking alcohol in moderation, supplementation of selenium, vitamins D, C, and A, and active folate in the diets of high risk women to support their bodies naturally ability to prevent damage and disease. Avoiding exposure to harmful environmental toxins, including unnecessary hormones, is recommended as healthcare data supports the fact that toxic chemicals within the environment have been linked to the cause of various cancers after being introduced to the human body via the ecosystem.
Breast tissue is of higher risk as many toxins affect this preferentially. Women are further advised to maintain a healthy weight and blood sugar, nurture their body's own natural system for detox, improve sleep habits, reduce stress, and get adequate exercise.
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