Research Hints at New Way to Tell If Breast Calcifications Are Cancerous

When radiologists look at breast calcifications on a mammogram, it can be hard to tell if they’re a sign of cancer (malignant) or not (benign). That’s because all calcifications look the same on a mammogram: small white spots in the breast tissue image.

As a result, many people end up having biopsies of what’s thought to be a suspicious spot, which then turns out to be benign.

A new study on how calcifications form and what they’re made of may lead to a more accurate way to classify them as benign or malignant.

The researchers analyzed breast tissue samples containing calcifications from people with benign breast disease and DCIS (ductal carcinoma in situ). They used a number of different tests (such as laser and electron microscopes and X-rays) to study the structure of the calcifications.

They found that calcifications form differently depending on whether they’re benign or cancerous. Benign calcifications were rounder with mineral layers forming evenly around the surface as they grew, similar to the growth rings on a tree. Cancerous calcifications were more rod-shaped and the mineral layers more irregular.

Study leader Bruce Fouke, PhD, said that the calcification structures the researchers discovered hadn’t been seen before. “[They] establish a brand-new classification scheme between benign breast disease and DCIS,” he said in a statement. Fouke is professor of earth science and environmental change and director of the Roy J. Carver Biotechnology Center at the University of Illinois-at Urbana-Champaign.

They also discovered the calcifications were made of amorphous calcium phosphate (“amorphous” means the mineral can change shape). Knowing breast calcifications are made of amorphous calcium phosphate may lead to new treatments because certain drugs can dissolve amorphous calcium phosphate.

For their next steps, the researchers plan to study the formation and structure of calcifications in invasive breast cancer, as well as figure out if and how calcifications play a role in DCIS progressing to invasive disease.