The purpose of this study is to evaluate breast microcalcifications according to morphology, distribution, level of suspicion, Breast Imaging Reporting and Data System (BI-RADS; fourth edition) final assessment, and recommendation categories and to assess positive predictive values and interobserver variability among three observers in 83 patients in whom biopsies had been performed. Although there is considerable inconsistencies in agreement between observers in the classification of microcalcifications, the usage of BI-RADS (fourth edition), in which the explicit recommendations for the description of the lesions was made, succeeds in the evaluation of microcalcifications.