These are typical secretory calcifications. These calcifications are dense, smooth and rod-like in a ductal distribution. They may be uni- or bilateral. Occasionally, early secretory calcifications may be difficult to distinguish from the linear, dot-dash calcifications of DCIS. Over time, secretory calcifications become denser and more cigar-like. In this patient, these had been stable for many years.
They are tubular and tram-tracking. As with secretory calcs, vascular calcifications can be difficult to discern when they are very early in formation, when the second half of the track may not be apparent. It is a real mammo faux pas to biopsy these.
Skin calcs are small with lucent centers. Many of the calcs in this case can be seen in tangent on the CC view. They are very common, especially after trauma and surgery (such as reduction mammoplasty).