ObjectiveTo evaluate the positive predictive value (PPV) of amorphous calcifications and to
analyze the imaging variables that could alter the risk of malignancy associated with
this finding.Materials and MethodsThis was a retrospective study of 138 stereotactically guided percutaneous
vacuum-assisted biopsies of amorphous calcifications, performed between January 2012 and
December 2017. All of the patients included were referred for radiological follow-up for
a minimum of one year (if the histopathology showed a benign lesion) or for surgical
treatment (if the histopathology showed malignancy or a lesion of uncertain malignant
potential).ResultsWe found that the PPV of amorphous calcifications was 9.42%. However, most of the
malignant amorphous calcifications were in cases of invasive carcinoma or high-grade
ductal carcinoma in situ, indicating clinically relevant disease. The relative risk of
malignancy associated with amorphous calcifications was 6.15 times higher in patients
with a family or personal history of breast or ovarian cancer. Neither being
postmenopausal nor having dense breasts was found to be predictive of malignancy in
patients with amorphous calcifications.ConclusionAmorphous calcifications in the breast had a PPV for malignancy of 9.42%, indicating
the possibility of placing the finding in subcategory 4a, which requires
histopathological analysis. Our finding that the risk of malignancy associated with this
subtype of calcifications is up to 6.15 times higher in patients with a family or
personal history of breast cancer warrants greater concern regarding the clinical,
radiologic, and histopathologic correlations after biopsy.