Sonographic assessment of breast calcifications

With widespread use of high-frequency sonography, breast imagers are beginning to commonly identify sonographic calcifications. The sonographic approach in assessing breast calcifications depends on whether the calcifications are initially identified sonographically or mammographically. If the calcifications are initially identified sonographically, a breast imager should first consider if the calcifications fit the characteristics of the American College of Radiology Breast Imaging Reporting and Data System Category 2—benign. If the calcifications are not benign, then one should assess the calcifications by their mammographic appearance. If the calcifications are initially identified mammographically, then the sonologist should be aware that one may not always visualize mammographic calcifications with sonography. Instead, if the radiologist seeks to localize mammographic calcifications with sonography, the imager should search for sonographic findings of invasive malignancy or ductal carcinoma in situ. These abnormalities include hypoechoic solid mass, focally dilated ducts, intraductal mass, or, rarely, isolated clustered calcifications.