Abstracts

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E1549. At the Edge of the Cliff: High-Risk Breast Lesions Presenting as Calcifications
Authors
  1. Nahill Matari; Rutgers New Jersey Medical School
  2. Anja Jones; Rutgers New Jersey Medical School
  3. Basil Hubbi; Rutgers New Jersey Medical School
  4. Magdalena Salvador; Rutgers New Jersey Medical School
Background
Calcifications can present a diagnostic dilemmas for mammographers. They can appear in a variety of ways on mammography and their heterogeneous subtlety can often mean the difference between routine follow-up and reassurance or biopsy. This exhibit aims to review how high risk lesions can present as calcifications and correlate their appearance on pathology to help guide mammography follow-up recommendations when faced with these lesions.

Educational Goals / Teaching Points
This exhibit will review how atypical ductal hyperplasia, atypical lobular hyperplasia/lobular carcinoma in situ, columnar cell hyperplasia, flat epithelial atypia, and papillary lesions can appear as calcifications on mammography. Specific attention will be given to the distribution pattern and morphologic appearance of the calcifications associated with these lesions. Each case will be correlated with biopsy results to demonstrate how mammographic appearance can help predict pathology. The exhibit will help viewers to make future follow-up decisions regarding calcified lesions.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Each reviewed high-risk lesion can present as calcifications on mammography. As such, correct interpretation can be dependent upon recognition of the relationship between the calcifications and their biopsy-proven pathologic correlates to recommend appropriate follow-up. Thus, this exhibit will demonstrate the distribution and morphology of calcifications in the context of atypical ductal hyperplasia, atypical lobular hyperplasia/lobular carcinoma in situ, columnar cell hyperplasia, flat epithelial atypia, and papillary lesions and correlate them with appearance on biopsy. This exhibit may increase the confidence of mammographers when interpreting a calcified high-risk lesion and making appropriate follow-up recommendations.

Conclusion
Recognizing that calcifications can represent high-risk lesions is of tantamount importance to the mammographer. This exhibit will present cases to demonstrate this relationship for viewers in the hopes that it can help guide future practice and facilitate decision-making to the benefit of patients.