Case 5 Answer
This cluster of calcifications is best described as punctate and amorphous. Punctate calcifications are tiny round dots. Amorphous calcifications "lacking shape" appear smudgy and poorly-defined on both CC and Lateral views.
If you said pleomorphic, you are not all that far off, but these do not quite have the multi-shaped dot-dashed appearance that fits the classic description of DCIS.
If you said round and coarse, well, you're a little off track. Check out this case to see several examples of classic benign calcs: Case 33
So, all that said, what is your recommendation?
- BI-RADS 1 - Normal - normal interval follow-up in 12 months
- BI-RADS 2 - Benign - normal interval follow-up in 12 months
- BI-RADS 3 - Probably Benign - 6 month follow-up
- BI-RADS 4 - Suspicious - recommend stereotactic biopsy
- BI-RADS 5 - Highly suggestive of malignancy - recommend image-guided needle biopsy