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Breast calcifications mimicking pulmonary nodules
On examination, her lung fields were clear, with no audible murmurs, and she had no lower-extremity edema. Her oxygen saturation was 98% on room air.
BREAST CALCIFICATIONS CAN MIMIC PULMONARY NODULES
Diffuse bilateral calcifications on mammography are typically benign and represent either dermal calcification (spherical lucent- centered calcification that develops from a degenerative metaplastic process) or fibrocystic changes.1 Up to 10% of women have fibroadenomas, and 19% of fibroadenomas have microcalcifications.2–4 Therefore, given the high prevalence, calcified breast masses should be considered in the differential diagnosis when evaluating initial chest radiographs in women.
Calcifications in the breast can overlie the lung fields and mimic pulmonary nodules. When assessing pulmonary nodules, prior imaging of the chest should always be assessed if available to determine if a lesion is new or has remained stable.
Given our patient’s age and 35-pack-year history of smoking, apparent pulmonary lesions caused concern and prompted chest CT to clarify the diagnosis. However, if the patient has no risk factors for lung malignancy, it can be safe to proceed with mammography.
By including breast calcifications in the differential diagnosis of apparent pulmonary nodules on chest radiography, the clinician can approach the case differently and inquire about a history of fibroadenomas and prior mammograms before pursuing a further workup. This can avoid unnecessary radiation exposure, the costs of CT, and apprehension in the patient raised by unwarranted concern for malignancy.
- Sitzman SB. A useful sign for distinguishing clustered skin calcifications from calcifications within the breast on mammograms. AJR Am J Roentgenol 1992; 158:1407–1408.
- Anastassiades OT, Bouropoulou V, Kontogeorgos G, Rachmanides M, Gogas I. Microcalcifications in benign breast diseases. A histological and histochemical study. Pathol Res Pract 1984; 178:237–242.
- Millis RR, Davis R, Stacey AJ. The detection and significance of calcifications in the breast: a radiological and pathological study. Br J Radiol 1976; 49:12–26.
- Santen RJ, Mansel R. Benign breast disorders. N Engl J Med 2005; 353:275–285.
On examination, her lung fields were clear, with no audible murmurs, and she had no lower-extremity edema. Her oxygen saturation was 98% on room air.
BREAST CALCIFICATIONS CAN MIMIC PULMONARY NODULES
Diffuse bilateral calcifications on mammography are typically benign and represent either dermal calcification (spherical lucent- centered calcification that develops from a degenerative metaplastic process) or fibrocystic changes.1 Up to 10% of women have fibroadenomas, and 19% of fibroadenomas have microcalcifications.2–4 Therefore, given the high prevalence, calcified breast masses should be considered in the differential diagnosis when evaluating initial chest radiographs in women.
Calcifications in the breast can overlie the lung fields and mimic pulmonary nodules. When assessing pulmonary nodules, prior imaging of the chest should always be assessed if available to determine if a lesion is new or has remained stable.
Given our patient’s age and 35-pack-year history of smoking, apparent pulmonary lesions caused concern and prompted chest CT to clarify the diagnosis. However, if the patient has no risk factors for lung malignancy, it can be safe to proceed with mammography.
By including breast calcifications in the differential diagnosis of apparent pulmonary nodules on chest radiography, the clinician can approach the case differently and inquire about a history of fibroadenomas and prior mammograms before pursuing a further workup. This can avoid unnecessary radiation exposure, the costs of CT, and apprehension in the patient raised by unwarranted concern for malignancy.
On examination, her lung fields were clear, with no audible murmurs, and she had no lower-extremity edema. Her oxygen saturation was 98% on room air.
BREAST CALCIFICATIONS CAN MIMIC PULMONARY NODULES
Diffuse bilateral calcifications on mammography are typically benign and represent either dermal calcification (spherical lucent- centered calcification that develops from a degenerative metaplastic process) or fibrocystic changes.1 Up to 10% of women have fibroadenomas, and 19% of fibroadenomas have microcalcifications.2–4 Therefore, given the high prevalence, calcified breast masses should be considered in the differential diagnosis when evaluating initial chest radiographs in women.
Calcifications in the breast can overlie the lung fields and mimic pulmonary nodules. When assessing pulmonary nodules, prior imaging of the chest should always be assessed if available to determine if a lesion is new or has remained stable.
Given our patient’s age and 35-pack-year history of smoking, apparent pulmonary lesions caused concern and prompted chest CT to clarify the diagnosis. However, if the patient has no risk factors for lung malignancy, it can be safe to proceed with mammography.
By including breast calcifications in the differential diagnosis of apparent pulmonary nodules on chest radiography, the clinician can approach the case differently and inquire about a history of fibroadenomas and prior mammograms before pursuing a further workup. This can avoid unnecessary radiation exposure, the costs of CT, and apprehension in the patient raised by unwarranted concern for malignancy.
- Sitzman SB. A useful sign for distinguishing clustered skin calcifications from calcifications within the breast on mammograms. AJR Am J Roentgenol 1992; 158:1407–1408.
- Anastassiades OT, Bouropoulou V, Kontogeorgos G, Rachmanides M, Gogas I. Microcalcifications in benign breast diseases. A histological and histochemical study. Pathol Res Pract 1984; 178:237–242.
- Millis RR, Davis R, Stacey AJ. The detection and significance of calcifications in the breast: a radiological and pathological study. Br J Radiol 1976; 49:12–26.
- Santen RJ, Mansel R. Benign breast disorders. N Engl J Med 2005; 353:275–285.
- Sitzman SB. A useful sign for distinguishing clustered skin calcifications from calcifications within the breast on mammograms. AJR Am J Roentgenol 1992; 158:1407–1408.
- Anastassiades OT, Bouropoulou V, Kontogeorgos G, Rachmanides M, Gogas I. Microcalcifications in benign breast diseases. A histological and histochemical study. Pathol Res Pract 1984; 178:237–242.
- Millis RR, Davis R, Stacey AJ. The detection and significance of calcifications in the breast: a radiological and pathological study. Br J Radiol 1976; 49:12–26.
- Santen RJ, Mansel R. Benign breast disorders. N Engl J Med 2005; 353:275–285.
