Which of the following is a benign mammographic finding?

• A. Irregular, pleomorphic calcifications
• B. Simple cysts (well-circumscribed, radiolucent)
• C. Architectural distortion
• D. Spiculated mass

Answer: (B)

On a mammogram, benign findings are typically well-defined and smooth, without suspicious calcifications or distortion. Simple cysts fit this pattern: they are fluid-filled sacs that appear as well-circumscribed, radiolucent (dark) areas with a thin, smooth wall. They do not cause the architectural distortion or irregular, pleomorphic calcifications associated with cancer, nor do they present as a spiculated mass, which are signs of malignancy. So, simple cysts are the classic benign mammographic finding. Irregular, pleomorphic calcifications, architectural distortion, and a spiculated mass are features that raise concern for malignancy.