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Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis
BACKGROUND: Microcalcifications (MCs) are tiny deposits of calcium in breast soft tissue. Approximately 30% of early invasive breast cancers have fine, granular MCs detectable on mammography; however, their significance in breast tumorigenesis is controversial. This study had two objectives: (1) to...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4407616/ https://www.ncbi.nlm.nih.gov/pubmed/25896922 http://dx.doi.org/10.1186/s12885-015-1312-z |
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author | Naseem, Madiha Murray, Joshua Hilton, John F Karamchandani, Jason Muradali, Derek Faragalla, Hala Polenz, Chanele Han, Dolly Bell, David C Brezden-Masley, Christine |
author_facet | Naseem, Madiha Murray, Joshua Hilton, John F Karamchandani, Jason Muradali, Derek Faragalla, Hala Polenz, Chanele Han, Dolly Bell, David C Brezden-Masley, Christine |
author_sort | Naseem, Madiha |
collection | PubMed |
description | BACKGROUND: Microcalcifications (MCs) are tiny deposits of calcium in breast soft tissue. Approximately 30% of early invasive breast cancers have fine, granular MCs detectable on mammography; however, their significance in breast tumorigenesis is controversial. This study had two objectives: (1) to find associations between mammographic MCs and tumor pathology, and (2) to compare the diagnostic value of mammograms and breast biopsies in identifying malignant MCs. METHODS: A retrospective chart review was performed for 937 women treated for breast cancer during 2000–2012 at St. Michael’s Hospital. Demographic information (age and menopausal status), tumor pathology (size, histology, grade, nodal status and lymphovascular invasion), hormonal status (ER and PR), HER-2 over-expression and presence of MCs were collected. Chi-square tests were performed for categorical variables and t-tests were performed for continuous variables. All p-values less than 0.05 were considered statistically significant. RESULTS: A total of 937 patient charts were included. About 38.3% of the patients presented with mammographic MCs on routine mammographic screening. Patients were more likely to have MCs if they were HER-2 positive (52.9%; p < 0.001). There was a significant association between MCs and peri-menopausal status with a mean age of 50 (64%; p = 0.012). Patients with invasive ductal carcinomas (40.9%; p = 0.001) were more likely to present with MCs than were patients with other tumor histologies. Patients with a heterogeneous breast density (p = 0.031) and multifocal breast disease (p = 0.044) were more likely to have MCs on mammograms. There was a positive correlation between MCs and tumor grade (p = 0.057), with grade III tumors presenting with the most MCs (41.3%). A total of 52.2% of MCs were missed on mammograms which were visible on pathology (p < 0.001). CONCLUSION: This is the largest study suggesting the appearance of MCs on mammograms is strongly associated with HER-2 over-expression, invasive ductal carcinomas, peri-menopausal status, heterogeneous breast density and multifocal disease. |
format | Online Article Text |
id | pubmed-4407616 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-44076162015-04-24 Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis Naseem, Madiha Murray, Joshua Hilton, John F Karamchandani, Jason Muradali, Derek Faragalla, Hala Polenz, Chanele Han, Dolly Bell, David C Brezden-Masley, Christine BMC Cancer Research Article BACKGROUND: Microcalcifications (MCs) are tiny deposits of calcium in breast soft tissue. Approximately 30% of early invasive breast cancers have fine, granular MCs detectable on mammography; however, their significance in breast tumorigenesis is controversial. This study had two objectives: (1) to find associations between mammographic MCs and tumor pathology, and (2) to compare the diagnostic value of mammograms and breast biopsies in identifying malignant MCs. METHODS: A retrospective chart review was performed for 937 women treated for breast cancer during 2000–2012 at St. Michael’s Hospital. Demographic information (age and menopausal status), tumor pathology (size, histology, grade, nodal status and lymphovascular invasion), hormonal status (ER and PR), HER-2 over-expression and presence of MCs were collected. Chi-square tests were performed for categorical variables and t-tests were performed for continuous variables. All p-values less than 0.05 were considered statistically significant. RESULTS: A total of 937 patient charts were included. About 38.3% of the patients presented with mammographic MCs on routine mammographic screening. Patients were more likely to have MCs if they were HER-2 positive (52.9%; p < 0.001). There was a significant association between MCs and peri-menopausal status with a mean age of 50 (64%; p = 0.012). Patients with invasive ductal carcinomas (40.9%; p = 0.001) were more likely to present with MCs than were patients with other tumor histologies. Patients with a heterogeneous breast density (p = 0.031) and multifocal breast disease (p = 0.044) were more likely to have MCs on mammograms. There was a positive correlation between MCs and tumor grade (p = 0.057), with grade III tumors presenting with the most MCs (41.3%). A total of 52.2% of MCs were missed on mammograms which were visible on pathology (p < 0.001). CONCLUSION: This is the largest study suggesting the appearance of MCs on mammograms is strongly associated with HER-2 over-expression, invasive ductal carcinomas, peri-menopausal status, heterogeneous breast density and multifocal disease. BioMed Central 2015-04-22 /pmc/articles/PMC4407616/ /pubmed/25896922 http://dx.doi.org/10.1186/s12885-015-1312-z Text en © Naseem et al.; licensee BioMed Central. 2015 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Naseem, Madiha Murray, Joshua Hilton, John F Karamchandani, Jason Muradali, Derek Faragalla, Hala Polenz, Chanele Han, Dolly Bell, David C Brezden-Masley, Christine Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis |
title | Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis |
title_full | Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis |
title_fullStr | Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis |
title_full_unstemmed | Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis |
title_short | Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis |
title_sort | mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4407616/ https://www.ncbi.nlm.nih.gov/pubmed/25896922 http://dx.doi.org/10.1186/s12885-015-1312-z |
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