Skin calcifications in the breast

Skin calcifications in the breast usually form in dermal sweat glands after low-grade folliculitis and the inspissation of sebaceous material. Calcifications may also form in moles and other skin lesions.  Often, these calcifications are in groups as they extend into small glands in the skin. 

Pathology

Dermal calcifications are usually related to a chronic inflammatory process such as folliculitis.

Radiographic features

Mammography

• are often of round or oval shape
• can have lucent centrescenters
• they may maintain the same relationship to each other on multiple mammographic views and this appearance is called the tattoo sign ^3-4
• have a lacelike pattern when associated with moles
• they tend to be widely scattered
• superficially located in the breast  (close to the skin on one view)
•  the most common locations include the axilla, inframammary fold, or medial part of the breast
• Similarsimilar size to skin pores
• Thethe presence of other skin calcifications makes them more likely

Differential diagnosis

• consider artifactual breast calcification on the skin from deodorants

Practical points

• Onon digital mammography or plain film mammography, tangential views with compression and a marker can be performed to verify that the questionable calcifications are located in the skin. Using
• the coordinates of calcifications are obtained using a mammographic compression plate with a localizing grid (a rectangular hole that has letters and numbers around the edge of the hole). The grid is placed directly over the skin containing the calcifications and a mammogram is taken.  While the patient is still in compression, the coordinates of the calcifications are obtained using the localizing grid and a metallic BB ismarker placed on the patient’s skin at the site of the calcification grid coordinates, then the technologist takes a mammogram tangential to the
• skin marker. Skin calcifications will be directly under the BB marker in the skin and intraparenchymal calcifications will be in breast tissue under the marker away from the skin.
• Onon tomosynthesis, skin calcifications can be easily identified because they are on the first or last slice of the study.