Grouped coarse heterogeneous calcifications are a group of irregular and conspicuous microcalcifications, smaller than dystrophic calcifications. They may be associated with malignancy, but they are also present in benign conditions, as fibroadenoma, in areas of fibrosis or trauma. A single group of coarse heterogeneous calcifications has a positive predictive value of slightly less than 15% and it should be placed in BI-RADS assessment category 4B (PPV range >10% to = 50%).