When Power Doppler Deceives: A Pseudovascular Breast Lesion Caused by Microcalcifications—Case Report

We report a case of a pseudovascular breast lesion caused by microcalcifications mimicking internal vascularity on Doppler ultrasonography. A middle-aged woman underwent routine screening, and mammography revealed benign-appearing punctate microcalcifications. Ultrasound showed a cystic lesion with apparent septal vascularity, initially raising suspicion for a complex lesion. However, further evaluation confirmed twinkle artifact due to intralesional microcalcifications. Recognition of this artifact prevented unnecessary biopsy. This case highlights the importance of integrating multimodal imaging and understanding Doppler artifacts in the accurate assessment of breast cystic lesions.