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Pseudocalcifications: Radiologic-Pathologic Correlation of Postsurgical Gauze Artifacts.

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Postsurgical mammograms can show linear radiodensities mimicking microcalcifications. These are often fragmented gauze foreign bodies, requiring awareness to prevent unnecessary patient interventions.

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Area of Science:

  • Radiology
  • Pathology
  • Surgical Complications

Background:

  • Artifacts and foreign bodies on mammograms can be mistaken for microcalcifications.
  • Postsurgical changes at the surgical bed require careful interpretation.

Purpose of the Study:

  • To identify and characterize radiodensities in postsurgical mammograms.
  • To determine the cause of fine linear radiodensities in the surgical bed.
  • To raise awareness of foreign body material as a mimic of microcalcifications.

Main Methods:

  • Retrospective review of mammograms from 17 postsurgical women with fine linear radiodensities.
  • Histopathological analysis of vacuum-assisted biopsy specimens.
  • Ex vivo reproduction of mammographic appearance using chicken breast.
  • In vivo study in mice implanted with gauze threads.

Main Results:

  • Mammograms revealed fine linear radiodensities in the surgical bed of 17 postsurgical women.
  • Histopathology confirmed foreign body material (fragmented gauze) with macrophage reaction.
  • Mammographic appearance was reproduced in chicken breast and mice models.
  • Identified gauze fragments as the source of the artifact.

Conclusions:

  • Fragmented gauze foreign bodies can mimic microcalcifications on mammograms.
  • Awareness of this entity is crucial to avoid unnecessary patient examinations and biopsies.
  • Postsurgical linear gauze fragments present challenges in mammographic follow-up.