Can Large Dystrophic Calcifications in Breast Guarantee Benignity?: A Case Report

• Published in: Ultrasonography (Seoul, Korea) Vol. 32; no. 3; pp. 202 - 206
• Main Authors: Hahm, Myong Hun, Hye Jung Kim, Lee, Sang Yub, Shin, Kyung Min, Cho, Seung Hyun, Ji Young Park, Jin Hyang Jung
• Format: Journal Article
• Language: English
• Published: Seoul Korean Society of Ultrasound in Medicine 01.09.2013; 대한초음파의학회
• Subjects: Ultrasonic imaging; 방사선과학
• ISSN: 2288-5919; 2288-5943

Dystrophic calcifications themselves in the breast are classified as typically benign according to the Breast Imaging Reporting and Data System. However, we experienced a patient with invasive ductal carcinoma surrounding large dystrophic calcifications that could be regarded as long-standing benign conditions such as fat necrosis or hematoma. A 61-year-old woman presented with two large dystrophic calcifications within an irregular mass in the right upper outer breast on mammography. Ultrasonography revealed an irregular mass with dense calcifications showing strong posterior acoustic shadowing. On contrast enhanced magnetic resonance imaging, an irregular mass showed a persistent enhancement pattern and high signal intensity on a diffusion weighted image with non-enhancing areas corresponding to the calcifications. No abnormal uptake was observed on Tc-99m methylene diphosphonate bone scan. Invasive ductal carcinoma was observed on ultrasonography-guided core needle biopsy. In this case, we conclude that typical dystrophic calcifications within a breast mass cannot guarantee a benign diagnosis if the imaging characteristics of the mass are suspicious.