This code system http://hl7.org/fhir/us/breast-radiology/CodeSystem/MammoCalcificationTypeCS defines the following codes:
| Code | Display | Definition |
| Amorphous | Amorphous | (historically, "indistinct")
These are sufficiently small and/or hazy in appearance
that a more specific particle shape
cannot be determined.
Amorphous calcifications in a grouped, linear, or
segmental distribution
are suspicious and generally warrant biopsy.
Bilateral, diffuse amorphous calcifications
usually may be dismissed as benign, although baseline
magnification views may be helpful.
The positive predictive value (PPV) of amorphous
calcifications is reported to be
approximately 20%.
Therefore, calcifications of this morphology appropriately
should be placed into BI-RADS assessment category
4B (PPV range > 10% to ? 50%).
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition]
Valid for the following modalities: MG. |
| Coarse | Coarse | The classic large 'popcorn-like' calcifications are
produced by involuting fibroadenomas.
These calcifications usually do not cause a diagnostic
problem.
When the calcifications in an fibroadenoma are small
and numerous, they may resemble malignant-type calcifications
and need a biopsy.
These are the classic large (> 2 to 3 mm in greatest
diameter) calcifications produced by an involuting
fibroadenoma.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition]
Valid for the following modalities: MG. |
| Dystrophic | Dystrophic | Dystrophic soft tissue calcification is a broad term
that encompasses a wide range of pathologies that
cause soft-tissue calcification and is caused by
calcification of damaged tissues.
The amorphous calcification that results may be
small or large.
In some cases, ossification may occur - this is
characterized by cortical formation and a central
medullary cavity.
[https://radiopaedia.org/articles/dystrophic-soft-tissue-calcification-1?lang=us]
Valid for the following modalities: MG. |
| Eggshell | Eggshell | Eggshell calcifications in the breast are benign
peripheral rim like calcifications
They are typically secondary to fat necrosis or calcification
of oil cysts.
thin rim-like calcification (<1 mm in thickness)
lucent centers
small to several centimeters in diameter (oil cyst)
may disappear (fat necrosis)
[https://radiopaedia.org/articles/eggshell-calcification-breast-1?lang=us]
Valid for the following modalities: MG. |
| Fine | Fine | These are thin, linear or curvilinear irregular calcifications
and may be discontinuous.
Valid for the following modalities: MG. |
| Generic | Generic | Calcification happens when calcium builds up in body
tissue, blood vessels, or organs.
This buildup can harden and disrupt the body's normal
processes.
Calcium is transported through the bloodstream and
is also found in every cell.
As a result, calcification can occur in almost any
part of the body.
Valid for the following modalities: MG. |
| CoarseHeterogeneous | Coarse Heterogeneous | These are irregular, conspicuous calcifications that
are generally between 0.5 mm and 1 mm
and tend to coalesce, but are smaller than dystrophic
calcifications.
They may be associated
with malignancy but more frequently are present in
a fibroadenoma or in areas of fibrosis or
trauma representing evolving dystrophic calcifications.
Numerous bilateral groups of coarse
heterogeneous calcifications usually may be dismissed
as benign, although baseline magnification
views may be helpful.
However, a single group of coarse heterogeneous calcifications
has a positive
predictive value of slightly less than 15%, and therefore
this finding should be
placed in BI-RADS assessment category 4B (PPV range
> 10% to ? 50%).
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition]
Valid for the following modalities: MG. |
| Indistinct | Indistinct | Amorphous calcifications, previously known as indistinct
calcifications, are a morphological
descriptor for breast calcifications that are small
and/or hazy such that no clearly
defined shape/form can be ascribed.
[https://radiopaedia.org > articles > amorphous-calcifications-breast]
Valid for the following modalities: MG. |
| LargeRodlike | Large rodlike | These benign calcifications associated with ductal
ectasia may form solid or discontinuous
smooth linear rods, most of which are 0.5 mm or larger
in diameter.
A small percentage of
these calcifications may have lucent centers if the
calcium is in the wall of the duct (periductal),
but most are intraductal, when calcification forms
within the lumen of the duct.
All large
rod-like calcifications follow a ductal distribution,
radiating toward the nipple, occasionally
branching.
The calcifications usually are bilateral, although
they may be seen in only one
breast, especially when few calcific particles are
visible.
These calcifications usually are seen
in women older than 60 years.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition]
Valid for the following modalities: MG. |
| Layering | Layering | Layering of calcium within the calcification.
[https://radiologyassistant.nl/breast/breast-calcifications-differential-diagnosis]
Valid for the following modalities: MG. |
| FineLinear | Fine Linear | Also called fine linear branching.
These are thin, linear, irregular calcifications,
which may be discontinuous and
which are
smaller than 0.5 mm in caliber.
Occasionally, branching forms may be seen.
Their appearance
suggests filling of the lumen of a duct or ducts
involved irregularly by breast cancer.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition page 66]
Valid for the following modalities: MG. |
| Lucent-centered | Lucent-centered | These are round or oval calcifications that range
from under 1 mm to over a centimeter.
They are the result of fat necrosis, calcified debris
in ducts, and occasional fibroadenomas.
[https://radiologyassistant.nl/breast/breast-calcifications-differential-diagnosis]
Valid for the following modalities: MG. |
| MilkOfCalcium | Milk of calcium | This is a manifestation of sedimented calcifications
in macro- or microcysts, usually but not
always grouped.
On the craniocaudal image they are often less evident
and appear as round,
smudgy deposits, while occasionally on MLO and especially
on 90 lateral (LM/ML) views,
they are more clearly defined and often semilunar,
crescent shaped, curvilinear (concave up),
or linear, defining the dependent portion of cysts.
The most important feature of these calcifications
is the apparent change in shape of the calcific particles
on different mammographic
projections (craniocaudal versus occasionally the
MLO view and especially LM/ML views).
At
times milk of calcium calcifications are seen adjacent
to other types of calcifications that may
be associated with malignancy, so it is important
to search for more suspicious forms, especially
those that do not change shape from the 90 lateral
projection to the CC projection.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition]
Valid for the following modalities: MG. |
| FinePleomorphic | Fine Pleomorphic | These calcifications are usually more conspicuous
than amorphous forms and are seen
to have
discrete shapes.
These irregular calcifications are distinguished
from fine linear and fine-linear
branching forms by the absence of fine-linear particles.
Fine pleomorphic calcifications vary in
size and shape and are usually smaller than 0.5 mm
in diameter.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition page 64]
Valid for the following modalities: MG. |
| Punctate | Punctate | Calcification is punctate/round.
It's different than a "round" calcification though
as it also means the calcifications are less than
.5 mm in size.
May warrant a probably benign (non-cancer) assessment
unless there is also a linear pattern or in a segmental
distibution.
This may require and imaging guided biopy or mammographic
surveillance.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition]
Valid for the following modalities: MG. |
| Rim | Rim | Eggshell or Rim Calcifications
These are very thin benign calcifications that appear
as calcium is deposited on
the surface of a sphere.
Fat necrosis and calcifications in the walls of cysts
are the most common "rim"
calcifications, although more extensive (and occasionally
thicker-rimmed) calcification
in the
walls of oil cysts or simple cysts may be seen.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition page 49]
Valid for the following modalities: MG. |
| Round | Round | When multiple, they may vary in size and therefore
also in opacity.
They may be considered
benign when diffuse and small (< 1 mm), and are frequently
formed in the acini of lobules.
When
smaller than 0.5 mm, the term "punctate" should be
used.
An isolated group of punctate calcifications may
warrant probably benign assessment and
mammographic surveillance if no prior examinations
are available for comparison, or
image-guided biopsy if the group is new, increasing,
linear or segmental in distribution, or if
adjacent to a known cancer.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition]
Valid for the following modalities: MG. |
| Skin | Skin | These are usually lucent-centered and pathognomonic
in their appearance.
Skin calcifications are most commonly seen along
the inframammary fold, parasternally, overlying the
axilla and around the areola.
The individual calcific particles usually are tightly
grouped, with individual
groups smaller than 5 mm in greatest dimension.
Skin calcifications may develop from a degenerative
metaplastic process.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition page 36]
Valid for the following modalities: MG. |
| Spherical | Spherical | Calcifications that have formed a spherical shape
are usually associated with benign
lesions.
[Breast Imaging Reporting and Data System—Ultrasound, Second Edition]
Valid for the following modalities: MG. |
| Suture | Suture | Calcified suture materials are typically linear or
tubular in appearance, and when present in Mammogram,
may show up in a knot pattern.
Valid for the following modalities: MG. |
| Vascular | Vascular | These are linear or form parallel tracks, that are
usually clearly associated with blood vessels.
Vascular calcifications noted in women
On the left typical vascular calcifications.
If only one side of a vessel is calcified, the calcification
may simulate intraductal (across a group of milk
ducts) calcification.
[https://radiologyassistant.nl/breast/breast-calcifications-differential-diagnosis]
Valid for the following modalities: MG. |
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