RIM 

SECRETORY

• Large rod-like calcs radiating from the nipple on mammography

• Must distinguish from fine linear calcifications bc they represent very different pathologic processes and implications. Distribution is a key distinguishing feature

  • Large rod-like - larger, denser, smoother, usually bilateral and diffuse or scattered = BIRADS 2

  • Fine linear - smaller in caliber, fainter, more discontinuous (dot-dash) in linear / segmental distribution = BIRADS 4 or 5

POPCORN

DYSTROPHIC

COARSE HETEROGENEOUS

• Discontinuous fine linear calcs are suspicious for DCIS and warrants bx

• Stereotactic bx should be performed unless there are patient factors precluding successful stereo such as...

  • Pt unable to lie prone

  • Thin breast compressing to <2 cm

  • Location not amenable to stero

• If unable to use stereotactic approach, then mammographic wire localization for surgical excision is required.

PLEOMORPHIC

• Have appearance of broken shards of glass with calcifications of varying size and shapes

• Typically more dense than amorphous calcifications

• Usually warrant bx independent of distribution.