https://orcid.org/0000-0003-3174-0610
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Prasann K Vachhani, Matthew M Miller, Unknown Case #7: Calcified Masses in the Breast and Axillae, Journal of Breast Imaging, Volume 2, Issue 3, May/June 2020, Pages 287–289, https://doi.org/10.1093/jbi/wbz057
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Extract
History
A 59-year old woman presented with a palpable lump in the right breast. She reported no personal or family history of cancer. Bilateral diagnostic mammography (Figure 1) and ultrasound of the right breast (Figure 2) and bilateral axillae (Figure 3) were performed.
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Imaging Findings
Key imaging findings included multiple oval circumscribed masses throughout the right breast, many of which were calcified, suspicious microcalcifications associated with irregular masses with indistinct margins, and bilateral calcified axillary lymphadenopathy. Subsequent staging computed tomography (Figure 4) demonstrated evidence of peritoneal carcinomatosis.
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Differential Diagnosis
Differential considerations for multiple breast masses with associated suspicious microcalcifications include fibroadenomas, papillomas, lymphoma/leukemia, ductal carcinoma in situ, multicentric breast cancer, and metastatic disease. The differential for bilateral calcified axillary lymphadenopathy includes granulomatous disease, gold therapy, tattoo particles, metastatic breast cancer, and metastatic disease. Given the morphology of the calcifications, the irregular shape of the masses, and the presence of bilateral lymphadenopathy, the most probable etiology explaining all of the imaging findings in this case is metastatic disease.
