Contributed by: Steven J. Rockoff, MD and Diana L. Lam, MD - June 1, 2020
A 67-year-old woman presents for a screening mammogram:
What is the dominant type of calcification that is present bilaterally? Representative magnified images are shown here:
A. Fine pleomorphic calcifications B. Large rod-like calcifications C. Vascular calcifications D. Fine-linear branching calcifications E. Skin calcifications
B. Large rod-like calcifications
Explanation: Large rod-like calcifications, also known as secretory calcifications, are benign calcifications associated with duct ectasia and are almost exclusively seen in post-menopausal women. They are often present in a bilateral diffuse distribution, as seen here. Large rod-like calcifications are thicker and larger than the similar-appearing fine linear or fine-linear branching calcifications, which are considered suspicious.
Note the difference between the large rod-like calcifications and the patient’s separate vascular calcifications shown here:
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Also note the far posterior intramammary lymph node in the left image.
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