Presentation
Work-up for exclusion of occult malignancy. Asymptomatic breast history.
Patient Data
Involuted breasts bilaterally appropriate for age with mild scattered fibroglandular densities.
Asymmetric density within the right breast, outer quadrant at 9 0'clock axis.
Extensive, bilateral, multifocal, linear, rod-like and cigar-shaped calcifications, oriented towards the nipples.
There are bilateral benign vascular calcifications.
There are no suspicious lymph nodes.
The asymmetric density was confirmed to represent benign findings on ultrasound-guided core biopsy. The post-biopsy MLO confirms the breast radio-opaque marker in situ.
Case Discussion
Features consistent with plasma cell mastitis, a benign breast condition
There are accompanying breast vascular calcifications too.
There is a well-demonstrated contrast between the dense, linear, rod-like and cigar-shaped calcifications of plasma cell mastitis versus the dense, linear, parallel and tram-track-like breast vascular calcifications. The calcifications of plasma cell mastitis are oriented towards the nipple, while the vascular calcifications follow a non-ductal, curvilinear pattern oriented away from the nipple.
In this instance, the presence of plasma cell mastitis and breast vascular calcifications were of no clinical concern in this post-menopausal elderly patient, however, the presence of either plasma cell mastitis or breast vascular calcifications may have clinical implications in a young and possibly symptomatic patient.
In young and symptomatic patients, plasma cell mastitis may present with erythema, swelling, heat, pain, pulsating lumps, nipple retraction, abscess and fistula formation1 while breast vascular calcifications may allude to premature coronary arterial disease, diabetes and hypercalcemic states including renal failure.
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