Suture calcification mimicking recurrence in the irradiated breast: a potential pitfall in mammographic evaluation

Development of microcalcifications at the primary excision site of the irradiated breast is a common manifestation of local tumor recurrence. The authors describe the mammographic appearances of benign suture calcifications, which, in some cases, can mimic recurrence on routine follow-up mammograms and include (a) a typical, knotted configuration, (b) a smooth, linear type, or (c) an apparent indeterminate cluster, which, when imaged with magnification technique, exhibits a more typical appearance. Pathologic examination demonstrates calcifications in the dead collagen that makes up catgut suture. Knowledge of these appearances and use of magnification technique in the evaluation of microcalcifications at the primary excision site may prevent unnecessary biopsy.