Screen‐detected breast carcinoma with macroscopic dystrophic calcification: A pictorial essay with radiolological pathological correlation

Abstract

Breast calcifications are among the most common abnormal radiographic findings detected at screening mammography. This essay illustrates the clinico-pathological features of nine screen-detected breast carcinomas, which had benign-appearing macrocalcifications, as a radiographically dominant presenting feature. We aimed to demonstrate that benign-appearing calcifications within a breast lesion are not diagnostic of a benign process if the other imaging characteristics of the lesion are suspicious of malignancy.

Metaplastic breast cancer mimicking a benign finding on mammography: a case report and literature review

“…In contrast, the calcifications in our case were dystrophic and developed insidiously with a malignant rapidly-growing mass. Calcifications in the breast are the most common abnormal radiographic findings detected on screening mammography 6 . Mammographic calcifications may be the only radiographic manifestation of breast cancer 7 .…”

“…The two cases with pleomorphic and coarse heterogeneous calcification reported in the literature had a diagnosis of MBC and were bone-forming 1 . On the other hand, only one case with a solid tumor and pleomorphic calcification diagnosed as a bone matrix-producing MBC was documented by Ebrahim 6 . A case of a woman with a high-grade carcinoma in situ associated with a benign dystrophic calcification into in a small oil cyst surrounded by neoplasia was also reported 6 .…”

“…On the other hand, only one case with a solid tumor and pleomorphic calcification diagnosed as a bone matrix-producing MBC was documented by Ebrahim 6 . A case of a woman with a high-grade carcinoma in situ associated with a benign dystrophic calcification into in a small oil cyst surrounded by neoplasia was also reported 6 . In contrast, the dystrophic calcification in our case corresponded to malignant calcification, and its association with a benign lesion by histopathology was ruled out.…”

“…Dystrophic calcifications are associated with benign processes such as fat necrosis, a history of trauma and surgery, irradiated breasts, or dystrophic subcutaneous dermatomyositis. Benign calcifications may coexist in breast tissue, abutting or incorporated into the malignant tumor as it grows 6 . The differential imaging diagnosis of malignant dystrophic breast calcification includes infiltrating ductal carcinoma 6 , low-grade ductal carcinoma in situ, and bone-producing tumors, such as bone metaplasia in a phyllodes tumor, primary breast sarcoma, mixed mammary fibromatosis, 6 and osteosarcoma.…”

“…Benign calcifications may coexist in breast tissue, abutting or incorporated into the malignant tumor as it grows 6 . The differential imaging diagnosis of malignant dystrophic breast calcification includes infiltrating ductal carcinoma 6 , low-grade ductal carcinoma in situ, and bone-producing tumors, such as bone metaplasia in a phyllodes tumor, primary breast sarcoma, mixed mammary fibromatosis, 6 and osteosarcoma. In our case report, malignant dystrophic calcification was the initial presentation of MBC bone formation.…”