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(Radiology. 2000;214:890-894.)
© RSNA, 2000

Breast Imaging

Metallic Punctate Densities in the Breast after Chinese Herbal Treatment: Mammographic Findings1

Woo Kyung Moon, MD, Jeong Mi Park, MD, Jung-Gi Im, MD, Dong-Young Noh, MD, Kyung Mo Yeon, MD and Man Chung Han, MD

1 From the Departments of Radiology (W.K.M., J.G.I., K.M.Y., M.C.H.) and Surgery (D.Y.N.), Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, Korea, and the Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.M.P.). Received February 19, 1999; revision requested April 5; revision received May 12; accepted June 28. W.K.M. supported by grant 01-99-047 from the Seoul National University Hospital Research Fund. Address reprint requests to W.K.M. (e-mail: moonwk@radcom.snu.ac.kr).

PURPOSE: To describe the mammographic features of metallic punctate densities seen in women who were treated with the herb go-yak for breast abscess and to explain the cause of these findings.

MATERIALS AND METHODS: Mammograms showing metallic punctate densities that appeared to be microcalcifications in 34 women were analyzed retrospectively with attention to the location, shape, distribution, and depth of the lesions. In all patients, go-yak was applied into the open wound after abscess drainage 6–42 years before mammography. In six patients, histopathologic specimens were obtained after needle localization.

RESULTS: Metallic densities were in the subareolar or central breast in 24 (71%) of 34 patients. The shape was predominantly round or punctate in all patients, but rod-shaped or linear lesions were found in seven patients. The distribution and depth of lesions were variable, but they extended to the subcutaneous fat in 29 patients (85%). A high concentration of lead was found in the histopathologic specimens and herb samples.

CONCLUSION: Lead deposits associated with go-yak treatment should be included in the differential diagnosis when the suspected microcalcifications are of unusually high density, are central in location, and extend into the subcutaneous fat in Asian women with a history of breast abscess.

Index terms: Breast, abnormalities, 00.811 • Breast, abscess, 00.212 • Breast, calcification, 00.811 • Breast, diseases, 00.212 • Breast neoplasms, diagnosis, 00.3113 • Breast radiography, 00.112, 00.113, 00.114, 00.115 • Foreign bodies, 00.46 • Lead