Breast calcifications

Breast calcifications may be found in benign or malignant breast specimens.

Calcification in benign breast tissue. H&E stain. (WC/Nephron)

General

• Abnormal breast calcifications are considered a marker of malignancy.
• Radiologists can pick-up calcifications that are approximately 100 micrometers; if "calcs" is on the requisition, the pathologist should be finding calcifications this size.
  • The large calcifications seen on radiology are approximately 1/5 - 1/6 the size of a HPF, if the field of view (FOV) is ~0.55 mm (as is the case with 22 mm-10x eye pieces and a 40x objective).

Types:

• Calcium phosphate - typically purple.
  • Q. How to remember? A. Purple = Phosphate.
• Calcium oxalate - not associated with malignancy.

Microscopic

Features of calcification:

• Purple globs (with concentric rings) on H&E - represent calcium phosphate.
• Often in the lumen of a gland, may be in the stroma.
• Calcific material typically has a well-demarcated border +/- "sharp corners".

Note:

• Calcium oxalate - visible with (light) polarization.

Images

• 

  CBBT - intermed. mag.

• 

  CBBT - high mag.

• 

  CBBT - very high mag.

See also

• Medial calcific sclerosis.
• Calcification.