0:00

In this case, we have a 73-year-old female presenting

0:03

for screening mammography. Looking at our image

0:07

quality, this looks like good image quality.

0:10

See good axillary muscles, uh, nipple in profile.

0:13

CC view.

0:14

Looks like they have enough posterior tissue.

0:17

We first pull down the MLO views closer.

0:20

Look at those.

0:22

On this left MLO, we do see some, uh, what

0:25

look like calcifications here, the very

0:27

far inferior aspect of the left breast.

0:31

Now you sort of might wonder, this one looks like

0:33

it, um, gets very close to the skin surface.

0:35

We got a little bit larger, so

0:37

you can see right along here.

0:39

Um, and so potentially these are in or on the skin.

0:45

The right breast looks like it's normal in this case.

0:49

On the left side again, we see these

0:50

calcifications and they're projecting in the

0:53

posterior aspect of the breast, which is where

0:55

we would expect them based on the MLO view.

0:58

And if we switch over to the DBT stack, um,

1:01

we notice right away on the inferior most

1:03

portion of the stack, you can see, uh, the

1:06

calcifications that we were interested in.

1:09

And we can see they have multiple, linear

1:11

sort of forms, almost cigar-shaped here.

1:14

Maybe a little bit.

1:16

You might sort of wonder, oh,

1:18

is that like a branch or something like that?

1:20

The thing that we need to realize is that

1:21

these things are actually in the skin.

1:23

This is in the very first slice.

1:24

Um, and as we scroll through,

1:28

we can see that there are no other

1:30

concerning calcifications on that side.

1:32

You can see this high-density one here,

1:34

but this is far superior breast and

1:37

very typically benign sort of appearance.

1:39

It doesn't match up with the ones that

1:40

we're looking at on the MLO.

1:42

So because these are in the skin,

1:43

we can therefore call them benign.

1:45

Nothing to worry about.

1:47

These may be true dermal calcs.

1:50

It's also possible, um, that this is

1:52

related to, um, a lotion sort of artifact.

1:55

Occasionally you can see that on

1:56

the inferior aspect of the breast.

1:59

Um, and patients either need to clean that area and

2:02

reimage, or, um, we can also just prove that these are

2:06

in the skin, nothing to worry about, um, and move on.

2:11

Recommend routine screening.

2:12

We can also look at prior exams to see

2:14

whether these were present previously.

2:16

If they were, then it's more likely to be dermal.

2:18

If it's something new, they're probably

2:20

more likely related to something external.

Normal Findings - Screening Mammogram - Dermal Calcifications

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Pro Tip: Click on a word in the transcript to jump to that point in the video

0:00

In this case, we have a 73-year-old female presenting

0:03

for screening mammography. Looking at our image

0:07

quality, this looks like good image quality.

0:10

See good axillary muscles, uh, nipple in profile.

0:13

CC view.

0:14

Looks like they have enough posterior tissue.

0:17

We first pull down the MLO views closer.

0:20

Look at those.

0:22

On this left MLO, we do see some, uh, what

0:25

look like calcifications here, the very

0:27

far inferior aspect of the left breast.

0:31

Now you sort of might wonder, this one looks like

0:33

it, um, gets very close to the skin surface.

0:35

We got a little bit larger, so

0:37

you can see right along here.

0:39

Um, and so potentially these are in or on the skin.

0:45

The right breast looks like it's normal in this case.

0:49

On the left side again, we see these

0:50

calcifications and they're projecting in the

0:53

posterior aspect of the breast, which is where

0:55

we would expect them based on the MLO view.

0:58

And if we switch over to the DBT stack, um,

1:01

we notice right away on the inferior most

1:03

portion of the stack, you can see, uh, the

1:06

calcifications that we were interested in.

1:09

And we can see they have multiple, linear

1:11

sort of forms, almost cigar-shaped here.

1:14

Maybe a little bit.

1:16

You might sort of wonder, oh,

1:18

is that like a branch or something like that?

1:20

The thing that we need to realize is that

1:21

these things are actually in the skin.

1:23

This is in the very first slice.

1:24

Um, and as we scroll through,

1:28

we can see that there are no other

1:30

concerning calcifications on that side.

1:32

You can see this high-density one here,

1:34

but this is far superior breast and

1:37

very typically benign sort of appearance.

1:39

It doesn't match up with the ones that

1:40

we're looking at on the MLO.

1:42

So because these are in the skin,

1:43

we can therefore call them benign.

1:45

Nothing to worry about.

1:47

These may be true dermal calcs.

1:50

It's also possible, um, that this is

1:52

related to, um, a lotion sort of artifact.

1:55

Occasionally you can see that on

1:56

the inferior aspect of the breast.

1:59

Um, and patients either need to clean that area and

2:02

reimage, or, um, we can also just prove that these are

2:06

in the skin, nothing to worry about, um, and move on.

2:11

Recommend routine screening.

2:12

We can also look at prior exams to see

2:14

whether these were present previously.

2:16

If they were, then it's more likely to be dermal.

2:18

If it's something new, they're probably

2:20

more likely related to something external.

Report

Faculty

Ryan W. Woods, MD, MPH

Assistant Professor of Radiology

University of Wisconsin School of Medicine and Public Health

Lesson

Pre-Course Activities

Lesson

Introduction to Tomosynthesis

Lesson

Approach to Interpretation and Lesion Localization

Lesson

Normal Imaging Findings

Lesson

Asymmetries and Masses

Lesson

Gynecomastia

Lesson

Fat-containing Lesions

Lesson

Architectural Distortion

Lesson

Calcifications

Lesson

Associated Findings

Lesson

Postsurgical Findings

Normal Findings - Screening Mammogram - Dermal Calcifications