Presentation
Routine mammogram study.
Patient Data
Single benign lobular calcifications and not anything else of note.
Developing heterogeneous microcalcifications deep and lateral to the areola and in the deep central parenchyma.
Mag view shows the heterogeneous nature of the calcifications.
Specimen radiograph showing the mammotome clip and localization wires of the sample.
Follow up 6 months later. Note the surgical clip and the small area of fat necrosis adjacent to the clip. There is now a developing group of heterogeneous calcifications laterally in the right breast (arrowed) highly suggestive of a developing DCIS focus. If you refer back to the initial image this area was clear of microcalcifications.
Case Discussion
The calcifications of DCIS underestimate the extent of disease. The importance of clear surgical margins is illustrated in this case. Note how the calcifications run almost to the margin of the specimen radiograph at the 2 o'clock radian.