Caracterización de lesiones asociadas a microcalcificaciones BI-RADS 4A, en 11 a？os de biopsias estereotáxicas

substantial advances in breast imaging techniques, especially developments in digital mammography, have led to early detection of breast cancer. it is well-known that microcalcifications are present in approximately 55% of nonpalpable breast malignancies and are responsible for the detection of 85-90% of cases of ductal carcinoma in situ (dcis) through mammographic screening. we evaluated the types of associated lesions and the percentage of malignancy in bi-rads 4a subcategory (low suspicion of malignancy), by performing a database review of stereotactic biopsies of microcalcifications categorized as bi-rads 4a, between september 1999 and january 2011, which accounted for 21.4% of biopsied microcalcifications in a total of 159 women. histological findings corresponded to benign lesions in 43.5%, high-risk lesions in 46.5%, and malignant tumors in 10%. concerning the latter (16 biopsies), 81.3% were dcis and 18.7% corresponded to infiltrating ductal carcinoma (idc). the ppv of bi-rads 4 a category was 13%, a value consistent with that described in the literature. microcalcifications bi-rads 4a exhibit low suspicion of malignancy, since they mostly correspond to benign lesions (90%). subcategory 4a constitutes an important ancillary diagnostic tool for a more accurate assessment of lesions suspicious for malignancy; therefore, we strongly recommend its use.