Mammographic artifact leading to false-positive result

A female, 75-year-old was referred by another service with previous screening mammogram demonstrating clustered pleomorphic microcalcifications in the superolateral quadrant of her left breast, classified as highly suspicious mammographic findings (BI-RADS category 5), to be submitted to mammographyguided needle localization followed by excisional biopsy of the suspicious lesion. A new mammography demonstrated an apparently benign nodule already present and stable in relation to the findings of the previous mammogram, besides the presence of clustered pleomorphic microcalcifications, both findings located in the superolateral quadrant of the left breast. The finding of suspicious microcalcifications drew attention for being a round-shaped cluster (Figures 1A and 1B). A new assessment detected a skin nevus with irregular surface presenting with talc residues in the lesion fissures. Once the lesion was marked with a metal clip, a new mammographic image revealed that the microcalcifications corresponded to artifacts related to the talc residues present on the dermal nevus surface (Figures 1C and 1D). The mammogram was reclassified as benign mammographic findings (BI-RADS category 2) and the patient was referred for follow-up at the public basic health network. Except for non-melanoma skin tumors, breast cancer is the most frequent neoplasm with high mortality in women in Brazil. Mammography is the main imaging method for the early diagnosis of breast cancer; and the analysis of the differences between normal breast tissue and suspicious findings requires high imaging quality for early detection of lesions. In addition, the presence of imaging artifacts reduces the sensitivity and specificity of imaging methods, masking or mimicking the diagnosis of initial-stage lesions and leading to the adoption os inappropriate approaches. radiological sings of diffuse alveolar process but this is not a specific finding in any of them. In the present case, the patient was healthy, with no comorbidity at the immediate postoperative period following upper airway surgery (tonsillectomy), presenting spontaneous resolution in only three days. Despite the nonspecificity of the radiological pattern, the preoperative history of the patient and the prompt resolution allowed for ruling out other causes, and NPPE was the only remaining possible diagnosis. Thus, the authors considered to be unnecessary to proceed with the diagnostic investigation with other imaging methods and laboratory tests.