Skin calcifications in the breast
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Skin calcifications in the breast usually form in dermal sweat glands after low grade-grade folliculitis and the inspissation of sebaceous material. Calcifications may also form in moles and other skin lesions. Often, these calcifications are in groups as they extend into small glands in the skin. Occasionally, tangential views are performed to verify that questionable calcifications are located in the skin.
Pathology
Dermal calcifications are usually related to a chronic inflammatory process such as folliculitis.
Radiographic features
Mammography
- are often of round or oval shape
- can have lucent
centerscentres - they may maintain the same relationship to each other on multiple mammographic views this appearance is called the tattoo sign 3-4
tangential view may be required to confirm dermal origin- have a lacelike pattern when associated with moles
- they tend to be widely scattered
- superficially located in the breast (close to the skin on one view)
- the most common locations include the axilla, inframammary fold, or medial part of the breast
- Similar size to skin pores
- The presence of other skin calcifications makes them more likely
Differential diagnosis
- consider artifactual breast calcification on the skin from deodorants
Practical points
- On digital mammography or plain film mammography, tangential views can be performed to verify that the questionable calcifications are located in the skin. Using a mammographic compression plate with a localizing grid (a rectangular hole that has letters and numbers around the edge of the hole). The grid is placed directly over the skin containing the calcifications and a mammogram is taken. While the patient is still in compression, the coordinates of the calcifications are obtained using the localizing grid and a metallic BB is placed on the patient’s skin at the site of the calcification grid coordinates, then the technologist takes a mammogram tangential to the skin marker. Skin calcifications will be directly under the BB in the skin and intraparenchymal calcifications will be in breast tissue under the marker away from the skin.
- On tomosynthesis, skin calcifications can be easily identified because they are on the first or last slice of the study.
-<p><strong>Skin calcifications in the breast</strong> usually form in dermal sweat glands after low grade folliculitis and inspissation of sebaceous material. Calcifications may also form in moles and other skin lesions. Often, these calcifications are in groups as they extend into small glands in the skin. Occasionally, tangential views are performed to verify that questionable calcifications are located in the skin.</p><h4>Pathology</h4><p>Dermal calcifications are usually related to a chronic inflammatory process such as folliculitis.</p><h4>Radiographic features</h4><h5>Mammography</h5><ul>- +<p><strong>Skin calcifications in the breast</strong> usually form in dermal sweat glands after low-grade folliculitis and the inspissation of sebaceous material. Calcifications may also form in moles and other skin lesions. Often, these calcifications are in groups as they extend into small glands in the skin. </p><h4>Pathology</h4><p>Dermal calcifications are usually related to a chronic inflammatory process such as folliculitis.</p><h4>Radiographic features</h4><h5>Mammography</h5><ul>
-<li>can have lucent centers</li>- +<li>can have lucent centres</li>
-<li>tangential view may be required to confirm dermal origin</li>-</ul><h4>Differential diagnosis</h4><ul><li>consider <a href="/articles/artifacts-that-mimic-breast-calcification-2">artifactual breast calcification</a> on skin from deodorants</li></ul>- +<li>superficially located in the breast (close to the skin on one view)</li>
- +<li> the most common locations include the axilla, inframammary fold, or medial part of the breast</li>
- +<li>Similar size to skin pores</li>
- +<li>The presence of other skin calcifications makes them more likely</li>
- +</ul><h4>Differential diagnosis</h4><ul><li>consider <a href="/articles/artifacts-that-mimic-breast-calcification-2">artifactual breast calcification</a> on the skin from deodorants</li></ul><h5>Practical points</h5><ol>
- +<li>On digital mammography or plain film mammography, tangential views can be performed to verify that the questionable calcifications are located in the skin. Using a mammographic compression plate with a localizing grid (a rectangular hole that has letters and numbers around the edge of the hole). The grid is placed directly over the skin containing the calcifications and a mammogram is taken. While the patient is still in compression, the coordinates of the calcifications are obtained using the localizing grid and a metallic BB is placed on the patient’s skin at the site of the calcification grid coordinates, then the technologist takes a mammogram tangential to the skin marker. Skin calcifications will be directly under the BB in the skin and intraparenchymal calcifications will be in breast tissue under the marker away from the skin.</li>
- +<li>On tomosynthesis, skin calcifications can be easily identified because they are on the first or last slice of the study.</li>
- +</ol>
References changed:
- 5. Debra Ikeda, Kanae Kawai Miyake. Breast Imaging. (2016) ISBN: 9780323329040 - <a href="http://books.google.com/books?vid=ISBN9780323329040">Google Books</a>
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