Skin calcifications in the breast
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Skin calcifications in the breast 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.
Dermal calcifications are usually related to a chronic inflammatory process such as folliculitis.
- are often of round or oval shape
- can have lucent centers
- may maintain the same relationship to each other on multiple mammographic views and this appearance is called the tattoo sign 3-4
- have a lacelike pattern when associated with moles
- 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
- consider artifactual breast calcification on the skin from deodorants
- on digital or plain film mammography, tangential views with compression and a marker can be performed to verify that calcifications are located in the skin
- the coordinates of calcifications are obtained using a mammographic compression plate with a localizing grid (a rectangular hole that has letters and numbers around the edge of the hole), and a metallic BB marker placed on the patient’s skin at the site of the calcification grid coordinates
- skin calcifications will be directly under the BB marker 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.