That Tiny Bit of Calcium

Dorothy Lamour (45) has dropped by the breast clinic to get herself "screened." After being told that the clinic is not part of a breast screening scheme, she pauses for a while, then complains about lumps she has felt in both breasts recently. On clinical examination, Hannah confirms the lumpy consistency of both breasts but cannot find any dominant lesion. Skywang repeats the examination and comes to the same conclusion. Mrs. Lamour does not know of any breast cancer in her family. Mammograms are done and put on the a b b

Irregular Calcification Breast

Fig. 12.10a The magnified view documents the invasion of the surrounding tissue by the cancer a little better. There are fine irregular calcifications in the center of the lesion (arrow). b Sonographically, Hannah sees an irregularly marginated, partially hypoechoic mass. This is definitely not a cyst. The minimally increased through-transmission does not change her opinion at all. c The MRI examination verifies the lesion and finds additional tumors in the same breast.

Fig. 12.10a The magnified view documents the invasion of the surrounding tissue by the cancer a little better. There are fine irregular calcifications in the center of the lesion (arrow). b Sonographically, Hannah sees an irregularly marginated, partially hypoechoic mass. This is definitely not a cyst. The minimally increased through-transmission does not change her opinion at all. c The MRI examination verifies the lesion and finds additional tumors in the same breast.

Mrs Lamour

I The Case of Dorothy Lamour

Fat Necrosis

I The Case of Dorothy Lamour

Dorothy Lamour Breasts

Fig. 12.11 This is the relevant magnified view of Mrs. Lamour's mammogram.

I Vascular Calcification

I Vascular Calcification

Vascular Calcification

Fig. 12.12 This vessel (arrows) displays fine, regular calcifications along its wall. This appearance is characteristic and can hardly be confused with more ominous intraductal calcifications.

Dorothy Lamour Breast

Fig. 12.11 This is the relevant magnified view of Mrs. Lamour's mammogram.

viewbox for analysis. Hannah collimates them carefully and studies them meticulously (Fig. 12.11). Are these not microcalcifications? She grabs the magnifying glass and starts to think about potential differential diagnoses.

Fig. 12.13 This magnification view shows the typical appearance of a necrosis of fatty tissue. The calcification is relatively large and round and has a central lucency. A calcification in the wall of a cyst would probably be coarser. The differentiation is a purely academic one, though, because neither entity is associated with an increased risk of malignancy.

Fat necrosis: This entity often presents as a relatively large calcification with a central lucency (Fig. 12.13). Its radiological characteristics are fairly reliable and may not require any further action other than the regularly scheduled follow-up examination.

Cysts: Cysts may show a similar appearance if they develop calcifications within their walls.

I Plasma Cell Mastitis

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