Mammographic Breast Pseudocalcifications Associated With Topical Betamethasone Dipropionate

Screening mammography plays a critical role in the early detection of breast cancer. Suspicious breast calcifications on mammography often prompt further diagnostic evaluation due to concern for malignancy, worrying physicians and patients alike. Here, we present a case of a woman in her 70s whose annual screening mammogram with digital breast tomosynthesis demonstrated two new groups of microcalcifications, confirmed after recall with magnification views. However, because of their superficial location, biopsy was thought to be too technically challenging and short follow-up was recommended. At 6-month mammographic follow-up, there was interval non-visualization of both calcifications. Additional clinical history interrogation revealed that due to a diffuse pruritic rash, the patient had been applying topical betamethasone dipropionate daily to her entire body, including her breasts, when she received her initial mammogram. This case illustrates how corticosteroid ointments and lotions may mimic suspicious calcifications on mammography, reinforcing the importance of guidelines recommending avoidance of topical products on the day of imaging.