Calcifications on mammograms at first look like little dust on the negative. These microscopic calcifications are sometimes a sign of cancer or precancerous lesions, which is why radiologists always detail any microscopic calcifications seen on x-rays in their reports. However, there is no need to panic, as 80% of calcifications are not related to cancer, but are simply the result of normal breast wear and tear. Calcium spills out of the bones with age and can be found in the arteries, causing atherosclerosis, or in the joints, causing arthritis. Most ultramicrocalcifications in the breast do not cause any problems (the presence of this calcium in the body is not related to how much calcium is consumed). Distinguish which calcifications are bad and which are harmless. We can look at their shape, size, and how numerous they are; if they are very small, densely clustered, and numerous, the chances of precancerous changes are high; if they are scattered throughout the breast, they are more likely to be benign. Pre-cancerous changes occur in the milk ducts, which are themselves very small, and only densely clustered and very small amounts of calcium can be present in the ducts. The large chunks of calcium seen on mammograms are unlikely to be tucked into the ductal system, so you can tell they are benign. Usually they are old fibrocysts that have been present since the teenage years and become softer and less dense in texture as they fade over time and eventually become calcified. If they calcify within the blood vessel, they can harden the vessel with age. If you can’t tell from the x-ray right away, your doctor will usually schedule another mammogram in 6 months. If it is caused by a precancerous lesion, more calcified spots will be found, or the shape and size of the calcification will change, otherwise it is almost certainly benign. That said, there are still certain pre-cancerous changes where the calcifications don’t grow or change fast enough to be detected from a second mammogram. Still, doctors sometimes recommend surgery based on the shape, size, and number of calcifications, among other characteristics.