Analysis of calcification in breast masses by high-resolution sonography

Objective To analyze and evaluate the size, shape and distribution characteristics of calcification in breast masses by high-resolution sonography for the differentiation of the benign masses from the malignant ones. Methods Fifty-one cases with calcification in which included 30 malignant and 21 benign masses in breast masses were evaluated and analyzed by high-resolution sonography . All cases had pathological results. Results According to the sizes, calcifications were classified: type 1, micro calcification; type 2, coarse calcification and type 3, curved calcification. Furthermore, micro calcifications were divided into three types due to their shapes and distributions: a, spot calcification, b, pearl calcification, c, clustered calcification. Of the 30 malignant cases, 29 were micro calcifications and only one coarse calcification, whereas 13 cases were micro calcifications, 4 were coarse calcification and 4 curved calcification in the 21 benign cases. Micro calcifications were more likely to be found in malignant diseases, and coarse calcification, curved calcification were more likely to be in benign diseases. There is a significant difference between the two groups (χ 2=12.22, P 0.001). Moreover, of the 42 micro calcifications, the calcification features of malignant masses tended to be appeared clustered distributions (22/42), and benign calcifications tended to be appeared single or loose distributions with pearl or spot micro calcifications (12/42). Statistic significance was different between malignant and benign masses (χ 2=16.44, P 0.001). Additionally, 7 malignant masses (7/42) appeared loose distributions of spot micro calcifications. Conclusion Clustered calcification can be characters of breast cancer. Most of pearl micro calcifications, coarse and curved calcifications with single or loose distributions are benign lesions. Spot micro calcification can be appeared in both malignant and benign lesions in which single or loosely sparse distributions are more likely to be benign lesions. Relatively accumulated distribution with two or more spot calcifications, combining with gray-scale and color Doppler sonographic features can improve the diagnostic accordance of breast cancer.