Background : Almost 3–21% of breast lesions have uncertain malignant potential (B3 lesions). Despite the low malignant potential of B3 lesions (0.2–5%), biopsy is performed to rule out invasive carcinoma. Materials and Methods: We retrospectively analyzed the mammography, ultrasonography, and pathological data of 109 patients with breast microcalcifications between January 2018 and March 2021. We also recorded the microcalcification size and histological type. Results: The patients had a mean age of 46.86 ± 9.65 years and mean microcalcification size of 13.78 ± 6.51 mm. Among B3 lesions, 74% and 25.9% had histopathological findings consistent and inconsistent with malignancy, respectively. Approximately 11.1% of the lesions were upgraded. The malignant potential was higher in postmenopausal patients older than 47 years with atypical ductal hyperplasia (p = 0.002). Conclusions: Breast microcalcifications require excisional biopsy in older and postmenopausal patients because of the upgrade risk; however, benign lesions can be followed with imaging and fine needle biopsy.

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