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Calcification in sclerosing adenosis simulating malignant breast calcification

Department of Diagnostic Radiology, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Road, London, W.12

This excerpt was created in the absence of an abstract.

Egan (1964) describing the calcifications found on mammography in breast carcinoma, states that "The typical calcifications are pathognomonic of carcinoma. They are so specific that in their presence a histologic diagnosis of benign disease usually indicates that either the surgeon has selected the wrong tissue for biopsy or that the pathologist is in error." We here present a patient who, on mammography had a lesion with the features of malignant calcification. Extensive and detailed histological examination demonstrated only a benign lesion.

A 54-year-old married female presented to the Breast Clinic at Hammersmith Hospital with a one month history of retraction of the left nipple. She had breast fed two children and was one year post-menopausal. In 1936, at the age of 19, she was diagnosed as having "chronic interstitial mastitis" of the left breast, and for this was given a course of radiotherapy extending over a two-month period. The estimated dose was 1,200 rads.

On examination at the present time the left breast was smaller than the right, with retraction of the nipple. No discrete mass was felt and there were no lymph nodes palpable. Skeletal survey and bone scan were normal. Mammography demonstrated a localized zone of numerous irregular fine punctate calcifications deep to the nipple. There was no associated mass, skin thickening, or evidence of large venous channels. This appearance was considered to be pathognomonic of malignant calcification.

^* Present address: Edgware General Hospital, Edgware,Middlesex.

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