1. Classification of breast calcification foci 1. According to breast imaging reporting and data system (BI-RADS) classification: Hu Wei, Department of Breast Surgery, Shanghai Changhai Hospital Based on the BI-RADS system developed by the American College of Radiology, calcification is classified into: category 0, incomplete assessment, requiring other imaging examinations Category 1, negative, no abnormal findings; Category 2, benign findings; Category 3, high possibility of benignity, short-term follow-up recommended (less than 1 year, generally 6 months), malignancy rate generally less than 2%; Category 4, suspicious of malignancy, consider biopsy, no characteristic morphological changes of breast cancer, but possible malignancy; Category 5, high suspicion of malignancy (almost certain malignancy), possibility of malignancy greater than equal to 95%; Category 6, biopsy confirmed malignant. 2, according to the benign and malignant classification: breast calcification is divided into three categories: typical benign, intermediate, and highly likely malignant. 3, according to morphological classification: typical benign calcification has eleven manifestations: coarse calcification of skin; vascular calcification; coarse or popcorn-like calcification; coarse rod-like calcification; round or dotted calcification; ring or eggshell-like calcification; hollow-like calcification; milk-like calcification; suture calcification, dystrophic calcification and dotted calcification. Intermediate calcifications or suspicious calcifications, including both indeterminate or faint and coarse inhomogeneous calcifications. Highly probable malignant calcifications also present in two forms, fine polymorphic calcifications (granular calcifications) and linear or linear branching calcifications (cast calcifications). The treatment of calcified breast foci The treatment of calcified breast foci is mainly divided into follow-up observation and biopsy characterization, and the next step of treatment is based on the biopsy pathology results. The biopsy characterization of calcified breast foci is the key process of treatment. Indications for biopsy: (1) biopsy surgery is mandatory for patients with BI-RADS grade 5; (2) biopsy is strongly recommended for patients with BI-RADS grade 4; (3) patients with BIRADS grade 3 are followed up, and if the patient has a strong fear of disease and actively requests surgery, imaging-guided McMurdo spin biopsy surgery can be considered. Severe coagulation dysfunction is a contraindication to biopsy. There are currently four types of biopsy methods for calcified foci: hollow needle aspiration, open surgical excision after localization with a locating hook, mammography-guided stereotactic McMurdo spin biopsy, and ultrasound-guided McMurdo spin biopsy]. Among them, McMurdoon-rotation biopsy is a minimally invasive biopsy surgical method developed in recent years, and the existing imaging guidance is mainly mammography-guided and ultrasound-guided. Compared with conventional open surgical biopsy, its superiority is mainly accurate, minimally invasive and aesthetic. The improved ability of ultrasound to detect microcalcifications is a prerequisite for ultrasound-guided McMurdo spin biopsy. Currently, it is mostly used clinically for the excision of calcified breast foci combined with hypoechoic masses. The outstanding advantages are: (1) exact biopsy sampling under real-time, dynamic ultrasound guidance; (2) fewer specimen tissue strips are required to excise the same amount of calcification; (3) the needle approach is parallel to the chest wall and from the base of the lesion, so it is not limited by the location of the lesion, superficial or tight to the chest wall. Given the current limitations of ultrasound instruments, it is not possible to detect simple calcified foci, especially scattered microcalcifications, so the application of this biopsy method is limited. Secondly, ultrasound-guided McMurdo spin biopsy requires a high level of experience and patience of the operating physician. Currently, ultrasound-guided McMurdo spin biopsy is not recommended for patients with a high suspicion of malignant breast masses and large lesions on ultrasound. In conclusion, the clear classification of breast calcified foci is the basis of diagnosis, and their accurate localization is a prerequisite for biopsy diagnosis. Mammotome minimally invasive spinotomy guided by mammography or high-frequency ultrasound enables more accurate localization and excision of breast calcified foci, complete removal of foci, and reduction of breast tissue damage, which is worth promoting in clinical practice.