Contributed by: Steven J. Rockoff, MD and Diana L. Lam, MD – June 1, 2020
Question 1
A 40-year-old woman is recalled from her screening mammogram to work-up calcifications in the right breast. Diagnostic magnification views (CC & ML) are obtained:
What kind of calcifications are these? (try zooming in on your browser if needed)
A. Dystrophic
B. Popcorn-like
C. Rim
D. Skin
E. Milk of calcium
Answer
E. Milk of calcium
Explanation: These calcifications appear amorphous on the CC projection, and have a semilunar or crescent-shaped morphology on the 90º lateral (LM) projection. This is the classic appearance of “milk of calcium”, which are sedimented calcifications within cysts. These are benign.
On the CC projection, they milk of calcium often does not have a discrete shape. When x-rays pass through in the perpendicular (lateral) direction, we can see the calcifications layering within the dependent portion of their cysts, creating the characteristic curvilinear or “tea cup” appearance.
