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Management of Microcalcifications Developing at the Lumpectomy Bed After Conservative Surgery and Radiation Therapy

Iil Günhan-Bilgen¹ and Ayenur Oktay

¹ Both authors: Department of Radiology, Ege University Hospital, Bornova, Izmir, Turkey 35100-TR.

View larger version (82K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —46-year-old woman with two previous operations (first operation revealed invasive ductal carcinoma, second operation disclosed fat necrosis at lumpectomy site) who presented for routine follow-up after breast conservation therapy. Collimated mediolateral oblique mammograms of left breast show evolution of benign fat necrosis calcifications. Four years after second operation, new microcalcifications have developed at operation site.

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —46-year-old woman with two previous operations (first operation revealed invasive ductal carcinoma, second operation disclosed fat necrosis at lumpectomy site) who presented for routine follow-up after breast conservation therapy. Collimated mediolateral oblique mammograms of left breast show evolution of benign fat necrosis calcifications. Microcalcifications progressed toward benign-appearing microcalcifications at each 6-month follow-up, and typical fat necrosis calcifications formed at 2 years.

View larger version (97K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —42-year-old woman (same patient as in Fig. 1A, 1B at presentation 4 years earlier) who presented for routine follow-up after breast conservation therapy. Collimated mediolateral oblique view mammogram of left breast shows microcalcifications at lumpectomy site that increased in number at 6-month follow-up. Biopsy revealed fat necrosis.

View larger version (173K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —33-year-old woman who presented for routine follow-up after breast conservation therapy. Collimated right craniocaudal mammogram obtained 2 years after therapy shows linear microcalcifications at lumpectomy quadrant that were classified as BI-RADS category 4. Biopsy revealed fat necrosis.

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4 —38-year-old woman who presented for routine follow-up after breast conservation therapy. Collimated magnification view shows pleomorphic, clustered microcalcifications that developed at lumpectomy quadrant 42 months after therapy. Histopathologic analysis yielded ductal carcinoma in situ.

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