Only skin deep: a pictorial review of skin and subcutaneous lesions

Many skin and subcutaneous lesions can be demonstrated on screening mammograms, and may mimic malignancy. Careful clinical history and meticulous annotation is paramount to avoid pitfalls in mammographic interpretation, inappropriate recall and further evaluation. The National Health Service Breast Screening Programme [1] states that radiographers should note on the screening sheet any significant or relevant symptoms reported by the women or observed during the examination.

We shall illustrate 20 examples of radiographer-annotated lesions and correlate them with their corresponding mammograms and ultrasounds. Examples include sebaceous glands, seborrhoeic keratosis, skin tags, dimples from underlying malignancy, surgical scars, artefacts mimicking microcalcification, distended veins of Mondor's disease, central venous thrombosis, iliac vein thrombosis as well as peau d'orange.

Correct annotation can help to avoid misdiagnosis, unnecessary recall, anxiety and further investigations. The importance of meticulous radiographer annotation is emphasized.