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Calcifications Associated with Lactational Changes of the Breast: Mammographic Findings with Histologic Correlation

Cecilia L. Mercado1, Tova C. Koenigsberg2, Diane Hamele-Bena3 and Suzanne J. Smith1

1 Department of Radiology, New York Presbyterian Hospital, 161 Fort Washington Ave., AP10, New York, NY 10032.
2 Institute for Breast Care, Hackensack University Medical Center, 20 Prospect Ave., Ste. 513, Hackensack, NJ 07601.
3 Department of Pathology, New York Presbyterian Hospital, New York, NY 10032.



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  		Fig. 1A. —39-year-old asymptomatic woman who had been lactating within 6 months of presentation. Craniocaudal spot-compression magnification mammograms of right (A) and left (B) breasts show several clusters of heterogeneous and granular calcifications. Some clusters display linear distribution.

 


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  		Fig. 1B. —39-year-old asymptomatic woman who had been lactating within 6 months of presentation. Craniocaudal spot-compression magnification mammograms of right (A) and left (B) breasts show several clusters of heterogeneous and granular calcifications. Some clusters display linear distribution.

 


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  		Fig. 1C. —39-year-old asymptomatic woman who had been lactating within 6 months of presentation. Photomicrograph of histopathologic specimen shows group of large, coarse microcalcifications in area of clustered dilated ducts. Note large microcalcifications (thick arrow) present in homogeneous, eosinophilic secretions in one duct and smaller microcalcification (thin arrow) in lobule displaying focal distention of lobular glands, consistent with lactational changes. (H and E, x50)

 


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  		Fig. 2A. —39-year-old asymptomatic woman. Mediolateral oblique mammogram of right breast shows multiple focal clusters of microcalcifications that are granular and heterogeneous in appearance.

 


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  		Fig. 2B. —39-year-old asymptomatic woman. Photomicrograph of histopathologic specimen shows coarse microcalcification in dilated duct. Note also homogeneous eosinophilic secretions in duct and acinar lumina. (H and E, x125)

 


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  		Fig. 3A. —39-year-old asymptomatic woman who had been lactating within 6 months of presentation. Craniocaudal spot-compression magnification mammograms of right (A) and left (B) breasts show scattered microcalcifications (arrow, B) that are heterogeneous in appearance with granular, linear, and casting forms.

 


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  		Fig. 3B. —39-year-old asymptomatic woman who had been lactating within 6 months of presentation. Craniocaudal spot-compression magnification mammograms of right (A) and left (B) breasts show scattered microcalcifications (arrow, B) that are heterogeneous in appearance with granular, linear, and casting forms.

 


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  		Fig. 3C. —39-year-old asymptomatic woman who had been lactating within 6 months of presentation. Photomicrograph of histopathologic specimen shows large, coarse microcalcifications in dilated ducts. (H and E, x125)

 


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  		Fig. 4A. —27-year-old woman who was lactating and who presented with bilateral nodularity. True lateral spot-compression magnification mammogram of left breast shows both scattered and focal clusters of heterogeneous microcalcifications.

 


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  		Fig. 4B. —27-year-old woman who was lactating and who presented with bilateral nodularity. Craniocaudal spot-compression magnification mammogram of left breast obtained 12 months after A shows scattered granular and heterogeneous microcalcifications. Parenchymal involution allows better visualization of occasional clusters in focal linear and branching pattern. Overall decrease in number of calcifications was noted.

 


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  		Fig. 4C. —27-year-old woman who was lactating and who presented with bilateral nodularity. Photomicrograph of histopathologic specimen of breast shown in A shows psammoma body—like microcalcification with concentric laminated structures in dilated acinus. Acinar cells display vacuolated cytoplasm and occasional luminal cytoplasmic buds representing lactational changes. (H and E, x375)

 

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