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Published in: Breast Cancer 4/2009

01-10-2009 | Original Article

A cluster of microcalcifications: women with high risk for breast cancer versus other women

Authors: Takayoshi Uematsu, Masako Kasami, Sachiko Yuen

Published in: Breast Cancer | Issue 4/2009

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Abstract

Background

Abnormal screening mammographic findings are the most common presentation of ductal carcinoma in situ, which usually appears as a cluster of microcalcifications. No report has documented the risk of malignancy between the finding of a cluster of microcalcifications and women with high risk of breast cancer.

Methods

We investigated the morphologic descriptors of a cluster of microcalcifications in women with a high risk for breast cancer and compared the results with the characteristics of a cluster of microcalcifications in other women. A retrospective review was performed for 81 non-palpable clusters of microcalcifications that had stereotactic vacuum-assisted breast biopsy.

Results

The frequency of malignancy associated with a cluster of microcalcifications was 27%. The 50% frequency of malignancy with high risk for breast cancer was higher, but not significantly so, than the 24% frequency of 71 cases without high risk for breast cancer (P = 0.125). The frequency of malignancy and ADH of a cluster of microcalcifications with high risk of breast cancer was 70%, significantly higher than the 30% frequency of 71 cases without high risk of breast cancer (P = 0.028).

Conclusions

A cluster of microcalcifications in women with high risk for breast cancer should be considered suspicious and referred for biopsy.
Literature
1.
go back to reference Morrow M, Schnitt SJ, Harris JR. Ductal carcinoma in situ and microinvasive carcinoma. In: Harris JR, editor. Disease of the breast. 2nd ed. Philadelphia: Lippincott; 2000. p. 383–401. Morrow M, Schnitt SJ, Harris JR. Ductal carcinoma in situ and microinvasive carcinoma. In: Harris JR, editor. Disease of the breast. 2nd ed. Philadelphia: Lippincott; 2000. p. 383–401.
2.
go back to reference Uematsu T, Yuen S, Kasami M, Uchida Y. Dynamic contrast-enhanced MR imaging in screening detected microcalcification lesions of the breast: is there any value? Breast Cancer Res Treat. 2007;103:269–81.PubMedCrossRef Uematsu T, Yuen S, Kasami M, Uchida Y. Dynamic contrast-enhanced MR imaging in screening detected microcalcification lesions of the breast: is there any value? Breast Cancer Res Treat. 2007;103:269–81.PubMedCrossRef
3.
go back to reference Kettritz U, Morack G, Decker T. Stereotactic vacuum-assisted breast biopsies 500 women with microcalcifications: radiological and pathological correlations. Eur J Radiol. 2005;55:270–6.PubMedCrossRef Kettritz U, Morack G, Decker T. Stereotactic vacuum-assisted breast biopsies 500 women with microcalcifications: radiological and pathological correlations. Eur J Radiol. 2005;55:270–6.PubMedCrossRef
4.
go back to reference Berg WA, Arnoldus CL, Teferra E, Bhargavan M. Biopsy of amorphous breast calcifications: pathologic outcome and yield at stereotactic biopsy. Radiology. 2001;221:495–503.PubMedCrossRef Berg WA, Arnoldus CL, Teferra E, Bhargavan M. Biopsy of amorphous breast calcifications: pathologic outcome and yield at stereotactic biopsy. Radiology. 2001;221:495–503.PubMedCrossRef
5.
go back to reference American College of Radiology. Breast imaging reporting and data system (BI-RADS). 4th ed. Reston: American College of Radiology; 2003. American College of Radiology. Breast imaging reporting and data system (BI-RADS). 4th ed. Reston: American College of Radiology; 2003.
6.
go back to reference Burnside ES, Ochsner JE, Fowler KJ, Fine KJ, Salkowski LR, Rubin DL, et al. Use of microcalcification descriptors in BI-RADS 4th edition to stratify risk of malignancy. Radiology. 2007;242:388–95.PubMedCrossRef Burnside ES, Ochsner JE, Fowler KJ, Fine KJ, Salkowski LR, Rubin DL, et al. Use of microcalcification descriptors in BI-RADS 4th edition to stratify risk of malignancy. Radiology. 2007;242:388–95.PubMedCrossRef
7.
go back to reference Lehman CD, Blume JD, Weatherall P, Thickman, Hylton N, Warner E. Screening women at high risk for breast cancer with mammography and magnetic resonance. Cancer. 2005;103:1898–905.PubMedCrossRef Lehman CD, Blume JD, Weatherall P, Thickman, Hylton N, Warner E. Screening women at high risk for breast cancer with mammography and magnetic resonance. Cancer. 2005;103:1898–905.PubMedCrossRef
8.
go back to reference Sickles EA. Periodic mammographic follow-up of probably benign lesions: results in 3, 184 consecutive cases. Radiology. 1991;179:463–8.PubMed Sickles EA. Periodic mammographic follow-up of probably benign lesions: results in 3, 184 consecutive cases. Radiology. 1991;179:463–8.PubMed
9.
go back to reference Evans A, Pinder S, Wilson R, Sibbering M, Poller D, Elston C, et al. Ductal carcinoma in situ of the breast: correlation between mammographic and pathologic findings. Am J Roentgenol. 1994;162:1307–11. Evans A, Pinder S, Wilson R, Sibbering M, Poller D, Elston C, et al. Ductal carcinoma in situ of the breast: correlation between mammographic and pathologic findings. Am J Roentgenol. 1994;162:1307–11.
10.
go back to reference Evans A. The diagnosis and management of pre-invasive breast disease: radiological diagnosis. Breast Cancer Res. 2003;5:250–3.PubMedCrossRef Evans A. The diagnosis and management of pre-invasive breast disease: radiological diagnosis. Breast Cancer Res. 2003;5:250–3.PubMedCrossRef
11.
go back to reference Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. American cancer society guidelines for screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75–89.PubMedCrossRef Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. American cancer society guidelines for screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75–89.PubMedCrossRef
12.
go back to reference Liberman L, Abramson AF, Squires FB, Glassman JR, Morris EA, Dershaw DD. The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories. Am J Roentgenol. 1998;171:35–40. Liberman L, Abramson AF, Squires FB, Glassman JR, Morris EA, Dershaw DD. The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories. Am J Roentgenol. 1998;171:35–40.
13.
go back to reference D’Orsi CJ. BI-RADS decoded: detailed guidance on potentially confusing issues. Radiol Clin N Am. 2007;45:751–63.PubMedCrossRef D’Orsi CJ. BI-RADS decoded: detailed guidance on potentially confusing issues. Radiol Clin N Am. 2007;45:751–63.PubMedCrossRef
14.
go back to reference Page DL, Rogers LW. Combined histologic and cytologic criteria for the diagnosis of mammary atypical ductal hyperplasia. Hum Pathol. 1992;23:1095–7.PubMedCrossRef Page DL, Rogers LW. Combined histologic and cytologic criteria for the diagnosis of mammary atypical ductal hyperplasia. Hum Pathol. 1992;23:1095–7.PubMedCrossRef
15.
go back to reference Tavassoli FA, Norris HJ. A comparison of the results of long-term follow-up for atypical intraductal hyperplasia and intraductal hyperplasia of the breast. Cancer. 1990;65:518–29.PubMedCrossRef Tavassoli FA, Norris HJ. A comparison of the results of long-term follow-up for atypical intraductal hyperplasia and intraductal hyperplasia of the breast. Cancer. 1990;65:518–29.PubMedCrossRef
16.
go back to reference Dershaw D. Does LCIS or ALH without other high-risk lesions diagnosed on core biopsy require surgical excision? Breast J. 2003;9:1–3.PubMedCrossRef Dershaw D. Does LCIS or ALH without other high-risk lesions diagnosed on core biopsy require surgical excision? Breast J. 2003;9:1–3.PubMedCrossRef
17.
go back to reference Cohen MA. Cancer upgrades at excisional biopsy after diagnosis of atypical lobular hyperplasia or lobular carcinoma in situ at core-needle biopsy: some reasons why? Radiology. 2004;231:617–21.PubMedCrossRef Cohen MA. Cancer upgrades at excisional biopsy after diagnosis of atypical lobular hyperplasia or lobular carcinoma in situ at core-needle biopsy: some reasons why? Radiology. 2004;231:617–21.PubMedCrossRef
18.
go back to reference Stomper PC, Cholewinski SP, Penetrante RB, Harlos JP, Tsangaris TN. Atypical hyperplasia: frequency and mammographic and pathologic relationships in excisional biopsies guided with mammography and clinical examination. Radiology. 1993;189:667–71.PubMed Stomper PC, Cholewinski SP, Penetrante RB, Harlos JP, Tsangaris TN. Atypical hyperplasia: frequency and mammographic and pathologic relationships in excisional biopsies guided with mammography and clinical examination. Radiology. 1993;189:667–71.PubMed
19.
go back to reference Page DL, Dupont WD, Rogers LW, Rados MS. Atypical hyperplastic lesions of the female breast. A long-term follow up study. Cancer. 1985;55:2698–708.PubMedCrossRef Page DL, Dupont WD, Rogers LW, Rados MS. Atypical hyperplastic lesions of the female breast. A long-term follow up study. Cancer. 1985;55:2698–708.PubMedCrossRef
20.
go back to reference Winchester DJ, Bernstein JR, Jeske JM, Nicholson MH, Hahn EA, Goldschmidt RA, et al. Upstaging of atypical ductal hyperplasia after vacuum-assisted 11-gauge stereotactic core needle biopsy. Arch Surg. 2003;138:619–23.PubMedCrossRef Winchester DJ, Bernstein JR, Jeske JM, Nicholson MH, Hahn EA, Goldschmidt RA, et al. Upstaging of atypical ductal hyperplasia after vacuum-assisted 11-gauge stereotactic core needle biopsy. Arch Surg. 2003;138:619–23.PubMedCrossRef
21.
go back to reference Stomper PC, Connolly JL. Ductal carcinoma in situ of the breast: correlation between mammographic and tumor subtype. Am J Roentgenol. 1992;159:483–5. Stomper PC, Connolly JL. Ductal carcinoma in situ of the breast: correlation between mammographic and tumor subtype. Am J Roentgenol. 1992;159:483–5.
22.
go back to reference Liberman L, Drotman M, Morris EA, LaTrenta LR, Abramson AF, Zakowski MF, et al. Imaging-histologic discordance at percutaneous breast biopsy. Cancer. 2000;89:2538–46.PubMedCrossRef Liberman L, Drotman M, Morris EA, LaTrenta LR, Abramson AF, Zakowski MF, et al. Imaging-histologic discordance at percutaneous breast biopsy. Cancer. 2000;89:2538–46.PubMedCrossRef
23.
go back to reference Foster MC, Helvier MA, Gregory NE, Rebner M, Nees AV, Paramagul C. Lobular carcinoma in situ or atypical lobular hyperplasia at core-needle biopsy: is excisional biopsy necessary? Radiology. 2004;231:813–9.PubMedCrossRef Foster MC, Helvier MA, Gregory NE, Rebner M, Nees AV, Paramagul C. Lobular carcinoma in situ or atypical lobular hyperplasia at core-needle biopsy: is excisional biopsy necessary? Radiology. 2004;231:813–9.PubMedCrossRef
Metadata
Title
A cluster of microcalcifications: women with high risk for breast cancer versus other women
Authors
Takayoshi Uematsu
Masako Kasami
Sachiko Yuen
Publication date
01-10-2009
Publisher
Springer Japan
Published in
Breast Cancer / Issue 4/2009
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-009-0100-5

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