Occult calcification of the breast is a type of occult breast lesion, which is a cluster of calcified foci in the breast with negative clinical signs and symptoms as shown by routine mammography. Nowadays, breast cancer has become the first malignant tumor that endangers women’s health. The early detection and standardized treatment of breast cancer can significantly improve the survival rate of patients, and occult breast calcification is one of the manifestations of early breast cancer. It is one of the most important aspects of tertiary cancer prevention in this century. Overseas statistics show that about 30% to 50% of breast malignant tumors are associated with microcalcifications. The relative risk of breast cancer is 47 times higher in patients with calcifications in the breast tissue than in those without calcifications. Calcifications on mammograms are usually seen in the form of lamellar calcifications, clusters of calcifications, and fine dots of microcalcifications. In contrast, the main morphology of malignant calcified foci are mucoid, bifurcated, and fine lines with blurred borders. In some of these breast cancer cases, there is no mass shadow, and the diagnosis is clear only by the typical features of malignant calcification. In clinical practice tiny, granular clusters of microcalcifications are an important early manifestation of breast cancer. The nature and extent of the lesion can be reflected by the morphology, size, number and density of the microcalcifications. Microcalcifications can be located in or around the lump, and a total number of 6-15 or more in 1 cm2 is highly suspected, especially if the density is uneven and the size is not equal. Mammography can improve the diagnosis rate of occult and early-stage cancers of the breast, and fine sand-type calcifications are often an alarm for malignant lesions; if there are also signs such as disturbance of the surrounding structures, asymmetry of both breasts and thickening of the vascular shadow, malignant lesions are more likely. Recently, we have admitted several patients with occult calcification foci on mammography, and intraoperative frozen pathology indicated malignant tumor. Breast-conserving surgery and modified radical surgery for breast cancer were also performed. Figure 1: The mammogram of the patient’s left breast suggested the presence of clusters of calcified foci, and we operated to remove the breast gland where the calcified foci were located. Intraoperative frozen pathology indicated ductal carcinoma in situ. Therefore, breast-conserving surgery was performed for the patient, and the margins around the cancer were cut in five directions: upper, lower, inner, outer and bottom, and frozen pathology was performed by our pathology department to assess whether there were cancer cells remaining or infiltrating. Figure 2: Schematic diagram of the incision range of modified radical breast cancer Early detection of occult calcified foci in the breast not only helps in early surgical treatment of breast cancer, but also makes it possible to avoid complications associated with breast-conserving surgery and axillary lymph node dissection. If the breast cancer has progressed to a certain stage, modified radical breast cancer surgery is required. As shown in Figure 2, the procedure involves removal of the nipple, a portion of the skin, the entire breast and the removal of the axillary lymph nodes. The surgery is extensive and invasive, and not only does the woman lose her secondary sexual characteristics, but there is also the inevitable possibility of surgery-related complications. The need for mammograms in women over 40 years of age is evident. Figure 3. The patient’s mammogram revealed scattered foci of calcification in the right breast, which was suspected to be malignant. With the help of our interventional ultrasound department, a coarse needle aspiration biopsy was performed and the pathology was clearly identified as ductal carcinoma in situ in the right breast. Therefore, breast-conserving surgery was performed after puncture and localization. With the change of social environment, the external environment brings many negative effects on human body. On the other hand new technical means of examination are increasingly advanced. More and more cancer patients are discovered and treated, and many fresh lives are taken away in front of our eyes. The high incidence of female breast tumors in China in recent years has drawn the attention of health administration and social groups at all levels. In recent years, health education and popularization of science, “pink ribbon” activities, and “female cancer screening” activities have been carried out continuously, and not less efforts have been invested in various aspects. However, many patients still miss the opportunity of early detection and treatment, or even adopt unregulated treatment methods, which brings unimaginable consequences. It is strongly recommended that women take care of themselves from every step of the way, especially breast examinations. Never let go of those untouchable but silent growing breast malignant tumors in the examination. Breast cancer is one of the most common malignant tumors in women, and it is also one of the most common malignant tumors that seriously affects patients’ physical and mental health and even endangers their lives. In the ancient language, “the upper doctor treats the untreated disease, the middle doctor treats the desired disease, and the lower doctor treats his own disease”. Many human cancers, including breast cancer, have no obvious clinical manifestation in the early stage, and it is only when the disease has developed to a certain extent that the patient will seek medical attention. However, there are still very few patients who are still ignorant when breast cancer has developed to a certain level, or they may seek medical help in a hurry, resulting in the delay of the disease, which then affects the effect of surgery and subsequent treatment. In my department, I have treated several patients with long duration of breast cancer. The breast lumps were hard, poorly mobile and not smooth, and individual breast skin dimple signs appeared. Such patients often require neoadjuvant chemotherapy to downgrade the stage of breast cancer. In some cases, the breast cancer tumor may even break down and surgery is required to remove the breast gland, axillary lymph nodes, and pectoralis major muscle for standard radical breast cancer treatment. Figure 4: In breast cancer patients, if the interstitial fibers of the breast tissue are invaded, invade the subcutaneous area or involve the Cooper’s ligament, the skin surface of the breast lesion often appears depressed to varying degrees, which is clinically called the “dimple sign”. The presence of dimple-like abnormalities indicates that the lesion is adherent to the skin. Figure 5: Breast ultrasound shows a 1.8×1.0 mass with hypoechoic parenchymal occupancy with unclear borders and “crab foot-like” tentacles extending around the mass. Such an infiltrative growth pattern of the breast mass strongly suggests malignancy, and the postoperative pathology clearly indicates invasive ductal carcinoma. In some cases, some older women delay breast cancer because they are afraid to seek medical help or because of other psychosocial factors. When the tumor develops to an advanced stage, the lump grows up and can make the skin bulge, and if the blood supply is insufficient, it can break down as the skin becomes red and thin. Patients are often accompanied by pain, sometimes severe pain. Due to the large amount of necrotic tissue and bloody secretions exuding from the trauma, patients often show signs of emaciation and anemia as a result. When they come to our clinic, the breast cancer tumor has already broken down and exuded, and the scope of surgical resection is large. Even after excision of the chest wall skin, autologous skin grafting was needed. For example, in Figure 6, we performed standard radical surgery for breast cancer and skin grafting at the same time. Postoperatively, the patient’s nutritional status and psychological status are taken into account, and the best way to successfully cure the patient is to improve her quality of life. Figure 6. An elderly female breast cancer patient with a breast cancer tumor invading the skin of the chest wall. After standard radical surgery for breast cancer, the skin of the chest wall was defective. Director Liang took the skin of the patient’s anterior medial thigh for chest wall skin grafting at the same time. It is never too late to mend, but for malignant tumors, it is better to treat them as early as possible. If the mass is small and the imaging does not suggest obvious malignancy, regular follow-up should be noted.