Breast Cancer Incidence According to Microcalcification Types on Mammogram

Kim, Jin; Lee, Jae Bok; Koo, Bum Hwan; Hwang, Jung Woong; Bae, Jeoung Won

Abstract

BACKGROUND: The major value of mammography lies in the detection of nonpalpable breast carcinomas and the mammographic appearance of clustered microcalcifications, and its predictive value in carcinomas of the breast has long been a subject of interest. Since the introduction of the fine needle localization biopsy, surgeons have performed biopsies for nonpalpable breast lesions, but there are many controversies over determining the guidelines for biopsy with only the findings of mammography.
METHODS
We reviewed the correlations between the type of mammographic appearance and the histopathologic diagnosis in 74 women who had nonpalpable breast lesions that appeared only as microcalcifications on the mammograms. We subdivided the types of microcalcifications into a casting type, a crushed-stone-like type and an amorphous type. The casting type has linear and branching patterns of microcalcifications, the crushed-stone-like type has clusters of granular microcalcifications, and the amorphous type has small punctuate powdery microcalcifications arranged irregularly.
RESULTS
The patients ages ranges from 25 to 82 years and 15 cases (20.3%) of breast cancer were detected among the 74 cases. Four (4) cases (28.6%) of breast carcinoma were detected in the 14 casting type cases, 8 (24.2%) in the 33 crushed-stone-like type cases, and 3 cases (11.1%) in the 27 amorphous type cases. The mean sizes of the benign and the malignant lesions were 13.11+/-11.72 mm and 12.47+/-9.46 mm, respectively, but there was no difference in size between breast carcinomas and benign lesions.
CONCLUSION
We conclude that women who have microcalcifications on their mammography should undergo biopsy, especially in cases of casting type or crushed-stone-like type microcalcifications to detect breast carcinomas at an early stage.