Mammographic predictors of the presence and size of invasive carcinomas associated with malignant microcalcification lesions without a mass.
OBJECTIVE
Our objective was to determine the degree with which mammographic features predict the presence and size of invasive carcinomas associated with malignant mammographic microcalcification lesions without a mass.


METHODS
Mammographic features were correlated with pathologic features in 304 consecutive breast carcinomas manifested by mammographic calcifications only in a prospective evaluation.


RESULTS
Mammographic calcifications associated with breast carcinoma had the final pathologic diagnoses of pure ductal carcinoma in situ (DCIS) in 65% of patients, DCIS with a focus of invasion in 32%, and invasive carcinoma only in 4%. Invasive foci were more likely associated with mammographic calcification size of 11 mm and greater (40%, 77/194) compared with 1-10 mm (26%, 29/110; p = 0.019). Invasive foci were also more likely associated with linear calcifications (44%, 55/126) compared with granular calcifications (29%, 51/178; p = 0.007). The frequency of invasion did not increase with calcification extents greater than 10 mm. The frequency of invasion ranged from 22% for less than or equal to 5-mm granular calcifications to 45% for linear calcifications of 11 mm and greater. Only 11% of cancers characterized by fine granular calcifications were associated with invasion as compared with 32% of those with coarse and mixed granular calcifications (p = 0.002).


CONCLUSIONS
Mammographic calcification features of malignant lesions cannot predict the absence of invasion with greater than 90% predictive value or predict the presence of invasion with greater than 45% predictive value. Increased extent of calcifications greater than 10 mm was not associated with greater likelihood of invasion.
Stomper
Paul C
PC
Department of Diagnostic Imaging, Roswell Park Cancer Institute, School of Medicine and Biomedical Sciences, Elm and Carlton Sts., SUNY at Buffalo, NY 14263, USA.
Geradts
Joseph
J
Edge
Stephen B
SB
Levine
Ellis G
EG
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index