Jennifer E. Ochsner MD, Presenter: Nothing to Disclose

Elizabeth Suzanne Burnside MD, Abstract Co-Author: Nothing to Disclose

Jeong Mi Park MD, Abstract Co-Author: Nothing to Disclose

Padmini V. Holla MD, Abstract Co-Author: Nothing to Disclose

Winifred K Leung BA, Abstract Co-Author: Nothing to Disclose

The Breast Imaging Reporting and Data System (BI-RADS) lexicon was developed to standardize the radiologist’s description and level of suspicion of observed findings on a mammogram. The recently released fourth edition of BI-RADS defines a new calcification descriptor: coarse heterogeneous. The purpose of this project is to evaluate the pathologic outcomes of isolated clustered coarse heterogeneous breast calcifications that undergo biopsy.

The films from 132 consecutive image-guided percutaneous biopsies during November 2001 – September 2002 were reviewed for analysis of calcification morphology. Seventeen of these biopsies were performed on coarse heterogeneous breast calcifications, as verified in a blinded manner by two independent fellowship-trained breast radiologists. The pathology of these specimens was then reviewed and correlation between radiology findings and biopsy results analyzed.

Percutaneous breast biopsy successfully obtained the targeted calcifications in 100% of the 17 specimens. Two (12%) of the lesions were malignant: one infiltrating ductal carcinoma and one ductal carcinoma in situ. The remaining lesions were benign including six cases of stromal calcifications (35%), four calcified fibroadenomas (23%), two areas of fibrosis with calcification (12%), two cases of fibrocystic change with calcification (12%), and one benign intraductal calcification (6%).

The majority of isolated clustered coarse heterogeneous calcifications biopsied demonstrate benign pathologic correlates. Over half of the calcifications were found to be either benign stromal calcifications or calcified fibroadenomas. However, one infiltrating ductal carcinoma and one ductal carcinoma in situ were identified. Therefore, it is appropriate that coarse heterogeneous calcifications be viewed with intermediate concern.

Ochsner, J, Burnside, E, Park, J, Holla, P, Leung, W, Coarse Heterogeneous Calcifications on Mammography: Pathologic Correlation.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4404202.html