Pathologic Analysis of Clustered Microcalcification Found on Mammograms: A Review of 77 Cases

Kang, Sun Hee; Chung, Ki Yong; Kim, You Sah; Choi, Jin Soo; Lee, Sang Sook

Abstract

PURPOSE
Clustered microcalcifications on mammogram represent an important feature of the breast cancer, especially that of intraductal carcinoma. The positive predictive value for malignancy of the clustered microcalcifications has been reported to be between 20 and 30%. This study was carried out to determine the radio-histological correlation of clustered microcalcifications seen on mammograms in a university hospital in Daegu, Korea. METHODS: The medical records of 77 consecutive patients who underwent wire localization biopsy for clustered microcalcifications between January 1997 and March 2001 were reviewed. Patients with palpable mass in the breast were excluded. All of the mammograms were read by a single radiologist and interpreted as at least category 3 or above according to the American College of Radiology Breast Imaging Reporting and Data System (BIRADS). The localization was done using a J wire in the Diagnostic radiology department in the morning on the day of surgery. Removal of the clustered microcalcifications was confirmed in each case with specimen mammography. RESULTS: All patient were female, with mean age of 47.7 years old. There was no complication from the procedures. Excision of the microcalcifications was incomplete in four patients, giving the successful complete excision rate of 94.8%. Pathologic report showed malignancy in 29.9% consisting of ductal carcinoma in situ in 19.5% and invasive carcinoma in 10.4%. Only one of eight patients with invasive carcinoma had axillary lymph node involvement. CONCLUSION: Needle localized surgical biopsy is safe, rapid, and accurate method for localizing small, potentially highly curable breast cancers with minimal sacrifice of breast tissue.