E3422. Now You See Me, Now You Don't: The Disappearing Act of Microcalcifications
  1. Chrissy Makariou-Pikis; MedStar Georgetown University Hospital
  2. Erin Crane; MedStar Georgetown University Hospital
  3. Judy Song; MedStar Georgetown University Hospital
  4. Erini Makariou; MedStar Georgetown University Hospital
Microcalcifications identified on mammography are crucial for the early detection of nonpalpable breast malignancies. Breast calcifications are common findings and are grouped into benign versus suspicious morphologies. Benign morphologies include skin, vascular, coarse, large rod-like, round, rim, dystrophic, milk of calcium, and suture calcifications. Suspicious morphologies include coarse heterogeneous, amorphous, fine pleomorphic, and fine linear or fine-linear branching calcifications, the risk of malignancy for which is 13%, 27%, 50%, and 78%, respectively. Increasing and newly appearing calcifications raise the suspicion for a malignant process. However, a rarely-reported phenomenon of disappearing calcifications may be associated with benign or malignant processes. When morphologically indeterminate calcifications are noted to decrease in number or demonstrate complete resolution on subsequent mammograms, a careful search should be completed for nearby new masses, architectural distortion, or increased asymmetry in the ROI. These findings may indicate a more ominous underlying condition.

Educational Goals / Teaching Points
Our aim is to highlight the significance of the “disappearing microcalcifications” in both benign and malignant processes through a series of cases.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A series of cases using mammography will feature calcifications and how they may relate to benign or malignant etiologies.

Our primary goal is to emphasize the importance of "disappearing calcifications" in both benign and malignant entities. Although most resolving or resolved calcifications are associated with benign conditions, it is important to remember the small association with malignant etiologies. A careful search for a nearby developing mass or asymmetry is warranted. We hope this presentation reminds the reader of this rare, yet significant, phenomenon.