Pleomorphic calcifications (crushed stone appearance) and some type of casting associated with ductal carcinoma in situ
Presentation
Patient undergoing mammography prevention screening.
Patient Data
The group of non-specific calcifications remained unchanged. After six months, however, a new group of pleomorphic calcifications (flattened stone morphology) and some casting-type calcifications appeared in a median position, malignant characteristics.
Six month earlier
A grouping of irregular, amorphous and non-specific calcifications can be seen in the mid-external quadrant of the right breast.
Case Discussion
This case illustrates the evolution at six months of a group of non-specific calcifications in the absence of suspicious opacities. The group of non-specific calcifications remained unchanged. After six months, however, a new group of pleomorphic calcifications (crushed stone morphology) and some casting type calcifications appeared in a median position. On stereotactic biopsy, the result was ductal carcinoma. Magnetic resonance imaging (not shown) was performed and found a higher proportion of pathological tissue than mammographic examination.
Often suspicious mammographic features are only the "tip of the iceberg" and underestimate the true extent of the tumor; MRI can help us detect the true extent of the disease, as in this patient's case.
Today, compared to the past, it is preferable to biopsy a group of amorphous calcifications immediately, without waiting for the evolution in the following six months.