In the natural history of the breast carcinomas, pre-clinical diagnosis may have positive effects on survival. Microcalcifications constitute an important part of non-palpable breast lesions and may be the first sign of a breast carcinoma. Objective and methods: We reviewed the pathological results from 85 patients with non-palpable breast lesion and malignant-appearing microcalcifications found on mammograms, and evaluated the correlation between the exams. Results: 28.4% were benign lesions of the breast, 36.3% were pre-malignant lesions, and 35.2% were carcinomas. Microcalcifications were more often associated with carcinoma “in situ” (54.8%) and ductal carcinoma (58.6%). Discussion and conclusion: The correlation between mammographic and pathological diagnosis has been reported to be between 68 and 98% in the detection of breast cancer. In our study, this correlation was 71.5% (kappa = 0.7). The association between BI-RADS lexicon and Le Gal classification maybe could reduce the ambiguity in assessment of breast microcalcification. Microcalcifications on the mammogram are not pathognomonic of carcinoma, but represent a high-risk area of the breast that requires a biopsy for histologic examination.