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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 2/2019

01-07-2019 | Conservative Therapy | Epidemiology

Does every woman presenting with malignant calcifications require a post lumpectomy mammogram?

Authors: Hálio Rodrigues-Duarte, Thiemo J. A. van Nijnatten, Tatiana Khoury, Hiram Cody, Stefanie Jacobs, Maxine S. Jochelson

Published in: Breast Cancer Research and Treatment | Issue 2/2019

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Abstract

Purpose

Successful breast-conserving surgery (BCS) followed by radiation therapy (XRT) is dependent on complete removal of the cancer with clear surgical margins, providing survival rates equivalent to those observed following mastectomy. In patients who have cancers presenting with microcalcifications, post lumpectomy mammograms (PLM) prior to radiation (XRT) can be performed to ensure that no cancer has been left behind. The purpose of this study was to assess the benefit of PLM in patients with malignant breast tumors presenting with microcalcifications.

Methods

In this IRB-approved retrospective study, we reviewed medical records for patients with breast cancers presenting with microcalcifications who underwent BCS between February 2008 and June 2013. 198 patients who had a PLM prior to XRT for cancers presenting with microcalcifications were included.

Results

Histopathology of the initial lumpectomy revealed invasive carcinoma in 78/198 (39.4%) and DCIS alone in 120/198 (60.6%). 114/198 (58%) patients had negative surgical margins. 7/114 (6%) patients with negative margins had positive PLM and re-excisions that were positive for malignancy: sensitivity 88%, specificity 95%, PPV 58%, NPV 99%. 84/198 patients had positive surgical margins. The diagnostic performance of PLM in this group was: sensitivity 55%, specificity 71%, PPV 66%, NPV 61%.

Conclusion

PLM plays an important role in the evaluation of patients undergoing breast conservation for breast cancer presenting with microcalcifications. Residual malignancy was detected on positive PLM in 6% of patients with negative margins.
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Metadata
Title
Does every woman presenting with malignant calcifications require a post lumpectomy mammogram?
Authors
Hálio Rodrigues-Duarte
Thiemo J. A. van Nijnatten
Tatiana Khoury
Hiram Cody
Stefanie Jacobs
Maxine S. Jochelson
Publication date
01-07-2019
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 2/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-019-05246-4

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