410 Obstetrics and Gynecology Board Review •••
❍ What mammographic features are most worrisome for the possibility of a breast malignancy?
Any density that is new or increasing in size in comparison to prior mammographic studies, clusters of
calcifications, especially very fine or linear calcifications, or a stellate or spiculated density.
Figure 41.2 Craniocaudal (CC) view mammogram showing
subareolar calcifications. Note the linear, irregular nature of the
calcifications, typical of ductal carcinoma in situ (DCIS).Figure 41.3 Medial-lateral oblique (MLO) mammogram. Note
the asymmetric mass with an irregular, spiculated appearance.
This lesion is worrisome for breast carcinoma.❍ What is the most ominous sign seen on mammography?
A stellate or speculated density, especially if associated with clustered calcifications.
❍ What unusual diagnostic difficulties are associated with infiltrating lobular carcinoma?
These tumors arise from a small focus of tumor that permeates extensively throughout the breast without an
associated concentrically enlarging central mass. This makes recognition difficult or impossible on mammogram.
❍ Does papillary carcinoma have a generally good or bad prognosis?
Good prognosis.