Breast carcinoma presenting as mammographic microcalcifications in axillary lymph nodes

While pleomorphic microcalcifications are commonly noted in the breast during mammography, the presence of such microcalcifications within axillary lymph nodes on mammography is rare. As there are no recent reported cases in the literature, this case report documents occult, metastatic papillary adenocarcinoma involving 5 of 16 lymph nodes in a patient presenting with microcalcifications in axillary nodes on mammography. More common causes of calcifications seen in axillary nodes on mammography are reviewed and include intranodal deposition of gold rather than calcium in patients treated for rheumatoid arthritis and as a sequelae in children following BCG vaccination. The technical approach for needle-directed biopsy of these microcalcifications is also discussed.