Histological correlation of mammographically detected breast calcifications – A need for rational protocols

Stereotactic biopsy is the preferred method for histological diagnosis of mammographic calcification. Radiography to assess the presence of calcification in biopsies before processing confirms whether the mammographic calcification is included in the biopsy. Often, the pathologist encounters the situation when calcification is present in the specimen x-ray but not in the histological sections. This may be because the paraffin block been incompletely sectioned or that the calcium been lost during processing. Further sections (beyond three levels) are examined to try to detect calcification. Many laboratories routinely examine these specimens in greater detail, including X-raying paraffin blocks to maximise the chance of finding calcification. Calcifications <100 microns (μm) size will be histologically apparent in involuted lobular units but are not visible on specimen radiographs. Recording this calcium as the radiographic abnormality represents a false-positive result. The review article outlines current practices for histological correlation of mammographic calcifications with recommendations for good practice.