Talcum powder masquerading as punctate microcalcification on mammmography
Presentation
Palpbale mass in the left breast and incidental finding in the right breast
Patient Data
Rt Mammo & tomosynthesis
Extensive, punctate hyperdensity projected in the supero-lateral aspect of the breast. No other diagnostic feature.
CC tomosynthesis: Most cephalad "slice" of the tomosynthesis
Rpt Mammo 5 days later when...
Rpt Mammo 5 days later when presented for stereotatic Bx of "calcification"
Punctate density has vanished - the patient's breast was thoroughly washed prior to performing this repeat examination.
Case Discussion
Talcum powder is a combination of talc (a radio-opaque mineral - hydrated magnesium silicate with the chemical formula H2Mg3(SiO3)4) and corn starch with perfumes. It causes an appearance typical of punctate micro-calcification. The key to diagnosis in the era of tomosynthesis is that the hyperdensity is not in the breast parenchyma (ie central slices) but on the skin edge ie the first or last slices of the tomosynthesis set.