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<ValueSet xmlns="http://hl7.org/fhir"> <id value="MammoCalcificationTypeVS"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><h2>Mammography Calcification Type ValueSet</h2><div><p>Mammography calcification types value set.</p> </div><ul><li>Include these codes as defined in <a href="CodeSystem-MammoCalcificationTypeCS.html"><code>http://hl7.org/fhir/us/breast-radiology/CodeSystem/MammoCalcificationTypeCS</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Amorphous">Amorphous</a></td><td>Amorphous</td><td>(historically, "indistinct") <br/>These are sufficiently small and/or hazy in appearance <br/>that a more specific particle shape <br/>cannot be determined. <br/>Amorphous calcifications in a grouped, linear, or <br/>segmental distribution <br/>are suspicious and generally warrant biopsy. <br/>Bilateral, diffuse amorphous calcifications <br/>usually may be dismissed as benign, although baseline <br/>magnification views may be helpful. <br/>The positive predictive value (PPV) of amorphous <br/>calcifications is reported to be <br/>approximately 20%. <br/>Therefore, calcifications of this morphology appropriately <br/>should be placed into BI-RADS assessment category <br/>4B (PPV range > 10% to ? 50%). <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Coarse">Coarse</a></td><td>Coarse</td><td>The classic large 'popcorn-like' calcifications are <br/>produced by involuting fibroadenomas. <br/>These calcifications usually do not cause a diagnostic <br/>problem. <br/>When the calcifications in an fibroadenoma are small <br/>and numerous, they may resemble malignant-type calcifications <br/>and need a biopsy. <br/>These are the classic large (> 2 to 3 mm in greatest <br/>diameter) calcifications produced by an involuting <br/>fibroadenoma. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Dystrophic">Dystrophic</a></td><td>Dystrophic</td><td>Dystrophic soft tissue calcification is a broad term <br/>that encompasses a wide range of pathologies that <br/>cause soft-tissue calcification and is caused by <br/>calcification of damaged tissues. <br/>The amorphous calcification that results may be <br/>small or large. <br/>In some cases, ossification may occur - this is <br/>characterized by cortical formation and a central <br/>medullary cavity. <br/>[https://radiopaedia.org/articles/dystrophic-soft-tissue-calcification-1?lang=us] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Eggshell">Eggshell</a></td><td>Eggshell</td><td>Eggshell calcifications in the breast are benign <br/>peripheral rim like calcifications <br/>They are typically secondary to fat necrosis or calcification <br/>of oil cysts. <br/>thin rim-like calcification (<1 mm in thickness) <br/>lucent centers <br/>small to several centimeters in diameter (oil cyst) <br/>may disappear (fat necrosis) <br/><br/> <br/>[https://radiopaedia.org/articles/eggshell-calcification-breast-1?lang=us] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Fine">Fine</a></td><td>Fine</td><td>These are thin, linear or curvilinear irregular calcifications <br/>and may be discontinuous. <br/><br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Generic">Generic</a></td><td>Generic</td><td>Calcification happens when calcium builds up in body <br/>tissue, blood vessels, or organs. <br/>This buildup can harden and disrupt the body's normal <br/>processes. <br/>Calcium is transported through the bloodstream and <br/>is also found in every cell. <br/>As a result, calcification can occur in almost any <br/>part of the body. <br/><br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-CoarseHeterogeneous">CoarseHeterogeneous</a></td><td>Coarse Heterogeneous</td><td>These are irregular, conspicuous calcifications that <br/>are generally between 0.5 mm and 1 mm <br/>and tend to coalesce, but are smaller than dystrophic <br/>calcifications. <br/>They may be associated <br/>with malignancy but more frequently are present in <br/>a fibroadenoma or in areas of fibrosis or <br/>trauma representing evolving dystrophic calcifications. <br/>Numerous bilateral groups of coarse <br/>heterogeneous calcifications usually may be dismissed <br/>as benign, although baseline magnification <br/>views may be helpful. <br/>However, a single group of coarse heterogeneous calcifications <br/>has a positive <br/>predictive value of slightly less than 15%, and therefore <br/>this finding should be <br/>placed in BI-RADS assessment category 4B (PPV range <br/><br/>> 10% to ? 50%). <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Indistinct">Indistinct</a></td><td>Indistinct</td><td>Amorphous calcifications, previously known as indistinct <br/>calcifications, are a morphological <br/>descriptor for breast calcifications that are small <br/>and/or hazy such that no clearly <br/>defined shape/form can be ascribed. <br/>[https://radiopaedia.org > articles > amorphous-calcifications-breast] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-LargeRodlike">LargeRodlike</a></td><td>Large rodlike</td><td>These benign calcifications associated with ductal <br/>ectasia may form solid or discontinuous <br/>smooth linear rods, most of which are 0.5 mm or larger <br/>in diameter. <br/>A small percentage of <br/>these calcifications may have lucent centers if the <br/>calcium is in the wall of the duct (periductal), <br/>but most are intraductal, when calcification forms <br/>within the lumen of the duct. <br/>All large <br/>rod-like calcifications follow a ductal distribution, <br/>radiating toward the nipple, occasionally <br/>branching. <br/>The calcifications usually are bilateral, although <br/>they may be seen in only one <br/>breast, especially when few calcific particles are <br/>visible. <br/>These calcifications usually are seen <br/><br/>in women older than 60 years. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Layering">Layering</a></td><td>Layering</td><td>Layering of calcium within the calcification. <br/>[https://radiologyassistant.nl/breast/breast-calcifications-differential-diagnosis] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-FineLinear">FineLinear</a></td><td>Fine Linear</td><td>Also called fine linear branching. <br/>These are thin, linear, irregular calcifications, <br/>which may be discontinuous and <br/>which are <br/>smaller than 0.5 mm in caliber. <br/>Occasionally, branching forms may be seen. <br/>Their appearance <br/>suggests filling of the lumen of a duct or ducts <br/>involved irregularly by breast cancer. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition page 66] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Lucent-centered">Lucent-centered</a></td><td>Lucent-centered</td><td>These are round or oval calcifications that range <br/>from under 1 mm to over a centimeter. <br/>They are the result of fat necrosis, calcified debris <br/>in ducts, and occasional fibroadenomas. <br/>[https://radiologyassistant.nl/breast/breast-calcifications-differential-diagnosis] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-MilkOfCalcium">MilkOfCalcium</a></td><td>Milk of calcium</td><td>This is a manifestation of sedimented calcifications <br/>in macro- or microcysts, usually but not <br/>always grouped. <br/>On the craniocaudal image they are often less evident <br/>and appear as round, <br/>smudgy deposits, while occasionally on MLO and especially <br/>on 90 lateral (LM/ML) views, <br/>they are more clearly defined and often semilunar, <br/>crescent shaped, curvilinear (concave up), <br/>or linear, defining the dependent portion of cysts. <br/>The most important feature of these calcifications <br/>is the apparent change in shape of the calcific particles <br/>on different mammographic <br/>projections (craniocaudal versus occasionally the <br/>MLO view and especially LM/ML views). <br/>At <br/>times milk of calcium calcifications are seen adjacent <br/>to other types of calcifications that may <br/>be associated with malignancy, so it is important <br/>to search for more suspicious forms, especially <br/>those that do not change shape from the 90 lateral <br/><br/>projection to the CC projection. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-FinePleomorphic">FinePleomorphic</a></td><td>Fine Pleomorphic</td><td>These calcifications are usually more conspicuous <br/>than amorphous forms and are seen <br/>to have <br/>discrete shapes. <br/>These irregular calcifications are distinguished <br/>from fine linear and fine-linear <br/>branching forms by the absence of fine-linear particles. <br/>Fine pleomorphic calcifications vary in <br/>size and shape and are usually smaller than 0.5 mm <br/>in diameter. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition page 64] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Punctate">Punctate</a></td><td>Punctate</td><td>Calcification is punctate/round. <br/>It's different than a "round" calcification though <br/>as it also means the calcifications are less than <br/>.5 mm in size. <br/>May warrant a probably benign (non-cancer) assessment <br/>unless there is also a linear pattern or in a segmental <br/>distibution. <br/>This may require and imaging guided biopy or mammographic <br/>surveillance. <br/><br/> <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Rim">Rim</a></td><td>Rim</td><td>Eggshell or Rim Calcifications <br/>These are very thin benign calcifications that appear <br/>as calcium is deposited on <br/>the surface of a sphere. <br/>Fat necrosis and calcifications in the walls of cysts <br/>are the most common "rim" <br/>calcifications, although more extensive (and occasionally <br/>thicker-rimmed) calcification <br/>in the <br/>walls of oil cysts or simple cysts may be seen. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition page 49] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Round">Round</a></td><td>Round</td><td>When multiple, they may vary in size and therefore <br/>also in opacity. <br/>They may be considered <br/>benign when diffuse and small (< 1 mm), and are frequently <br/>formed in the acini of lobules. <br/>When <br/>smaller than 0.5 mm, the term "punctate" should be <br/>used. <br/>An isolated group of punctate calcifications may <br/>warrant probably benign assessment and <br/>mammographic surveillance if no prior examinations <br/>are available for comparison, or <br/>image-guided biopsy if the group is new, increasing, <br/>linear or segmental in distribution, or if <br/><br/>adjacent to a known cancer. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Skin">Skin</a></td><td>Skin</td><td>These are usually lucent-centered and pathognomonic <br/>in their appearance. <br/>Skin calcifications are most commonly seen along <br/>the inframammary fold, parasternally, overlying the <br/>axilla and around the areola. <br/>The individual calcific particles usually are tightly <br/>grouped, with individual <br/>groups smaller than 5 mm in greatest dimension. <br/>Skin calcifications may develop from a degenerative <br/>metaplastic process. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition page 36] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Spherical">Spherical</a></td><td>Spherical</td><td>Calcifications that have formed a spherical shape <br/>are usually associated with benign <br/>lesions. <br/>[Breast Imaging Reporting and Data System—Ultrasound, Second Edition] <br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Suture">Suture</a></td><td>Suture</td><td>Calcified suture materials are typically linear or <br/>tubular in appearance, and when present in Mammogram, <br/>may show up in a knot pattern. <br/><br/><br/>Valid for the following modalities: MG.</td></tr><tr><td><a href="CodeSystem-MammoCalcificationTypeCS.html#MammoCalcificationTypeCS-Vascular">Vascular</a></td><td>Vascular</td><td>These are linear or form parallel tracks, that are <br/>usually clearly associated with blood vessels. <br/>Vascular calcifications noted in women <br/>On the left typical vascular calcifications. <br/>If only one side of a vessel is calcified, the calcification <br/>may simulate intraductal (across a group of milk <br/><br/>ducts) calcification. <br/>[https://radiologyassistant.nl/breast/breast-calcifications-differential-diagnosis] <br/><br/>Valid for the following modalities: MG.</td></tr></table></li></ul></div> </text> <url value="http://hl7.org/fhir/us/breast-radiology/ValueSet/MammoCalcificationTypeVS"/> <version value="0.2.0"/> <name value="MammoCalcificationTypeVS"/> <title value="Mammography Calcification Type ValueSet"/> <status value="draft"/> <date value="2019-11-01T00:00:00+00:00"/> <publisher value="Hl7 - Clinical Interoperability Council"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/Special/committees/cic"/> </telecom> </contact> <description value="Mammography calcification types value set."/> <jurisdiction> <coding> <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> <code value="001"/> </coding> </jurisdiction> <compose> <include> <system value="http://hl7.org/fhir/us/breast-radiology/CodeSystem/MammoCalcificationTypeCS"/> <concept> <code value="Amorphous"/> <display value="Amorphous"/> </concept> <concept> <code value="Coarse"/> <display value="Coarse"/> </concept> <concept> <code value="Dystrophic"/> <display value="Dystrophic"/> </concept> <concept> <code value="Eggshell"/> <display value="Eggshell"/> </concept> <concept> <code value="Fine"/> <display value="Fine"/> </concept> <concept> <code value="Generic"/> <display value="Generic"/> </concept> <concept> <code value="CoarseHeterogeneous"/> <display value="Coarse Heterogeneous"/> </concept> <concept> <code value="Indistinct"/> <display value="Indistinct"/> </concept> <concept> <code value="LargeRodlike"/> <display value="Large rodlike"/> </concept> <concept> <code value="Layering"/> <display value="Layering"/> </concept> <concept> <code value="FineLinear"/> <display value="Fine Linear"/> </concept> <concept> <code value="Lucent-centered"/> <display value="Lucent-centered"/> </concept> <concept> <code value="MilkOfCalcium"/> <display value="Milk of calcium"/> </concept> <concept> <code value="FinePleomorphic"/> <display value="Fine Pleomorphic"/> </concept> <concept> <code value="Punctate"/> <display value="Punctate"/> </concept> <concept> <code value="Rim"/> <display value="Rim"/> </concept> <concept> <code value="Round"/> <display value="Round"/> </concept> <concept> <code value="Skin"/> <display value="Skin"/> </concept> <concept> <code value="Spherical"/> <display value="Spherical"/> </concept> <concept> <code value="Suture"/> <display value="Suture"/> </concept> <concept> <code value="Vascular"/> <display value="Vascular"/> </concept> </include> </compose> </ValueSet>