Tattoo pigment mimicking axillary lymph node calcifications on mammography

Axillary lymph nodes can appear abnormal on mammography due to uptake of tattoo pigment and a malignant cause must be excluded through diagnostic workup. Furthermore, tattoo pigment can mimic malignant pathology at surgery or confound appropriate staging of breast cancer. We present the case of a 47-year-old female with left axillary lymph nodes demonstrating new coarse densities suspicious for malignant calcifications on screening mammogram. Stereotactic guided biopsy was performed which demonstrated pigment from a recent tattoo located on the patient's back and/or flank. Awareness of current or prior tattoos in a patient is helpful to properly manage such cases.