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A 23-year-old woman who had emigrated from Cameroon two years previously was admitted because of bilateral breast lumps. Her history was unremarkable. On physical examination, several nonpainful, mobile, firm lumps were detected in both breasts. The axillary lymph nodes were not involved. Mammography showed multiple serpiginous, tubular calcifications, which are characteristic of calcified filariasis, in both breasts.
Filarial infection of the breast, though uncommon, is not rare. The larvae enter the lymphatic vessels of the mammary gland, causing lymphangitis, fibrosis, and disruption of lymphatic drainage. The larvae appear in late, inactive phases as serpiginous calcifications. Because patients with these parasites present with lumps in the breast, the findings are a cause for concern, since they are often clinically suspected to be malignant. Despite the current global campaign to eliminate filariasis, the appearance of filarial infection on mammography is likely to be observed more frequently, because immigrants from areas where filariasis is endemic are settling in increasing numbers in developed countries.
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