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Atlas of breast cancer early detection

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Case number:150
Clinical presentation:Postmenopausal woman with average risk of developing breast cancer presented for mammography screening.


Breast composition:ACR category b (there are scattered areas of fibroglandular density)
Mammography features:

 ‣ Location of the lesion:Bilateral breasts, vascular calcifications
 ‣ Mass:
   • Number:0
   • Size:None
   • Shape:None
   • Margins:None
   • Density:None
 ‣ Calcifications:
   • Typically benign:Typically benign vascular calcifications
   • Suspicious:None
   • Distribution:None
 ‣ Architectural distortion:None
 ‣ Asymmetry:None
 ‣ Intramammary node:None
 ‣ Skin lesion:None
 ‣ Solitary dilated duct:None
 ‣ Associated features:None


BI-RADS Category: 2 (benign)

Case summary:

Postmenopausal woman with average risk of developing breast cancer presented for mammography screening. Diagnosed as bilateral breast typically benign vascular calcification, BI-RADS 2 on imaging.

Learning points:

  • Vascular calcifications are seen in the breast as linear parallel calcifications. Breast vessels show changes of atherosclerotic intima calcific foci similar to other arterial wall calcifications. It is easy to differentiate these from malignant linear calcifications, which form in the duct lumen within the necrotic cellular debris of the malignant mass and are seen as single linear branching calcifications. Vascular calcifications are always parallel lines in the arterial walls and are confidently labelled as typically benign-appearing calcifications of BI-RADS 2 category. There is no further assessment or follow-up suggested for the vascular calcifications.

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