Combined texture analysis and machine learning in suspicious calcifications detected by mammography: Potential to avoid unnecessary stereotactical biopsies

•Combined texture analysis and machine-learning can diagnose malignancy in mammographic BI-RADS 4 calcifications.•The machine-learning classifier demonstrated the potential to avoid more than one third of unnecessary biopsies.•A rule-out criterion to exclude malignancy with high certainty was identified and successfully tested.