Microcalcifications of the breast: how does radiologic classification correlate with histology?
OBJECTIVE
To assess the correlation between the pre-biopsy classification of microcalcifications and the underlying histology.


METHODS
Using the morphology and distribution patterns according to the Breast Imaging-Reporting and Data System (BI-RADS) lexicon, the microcalcifications of 199 lesions in 163 consecutive patients scheduled to undergo 11 G vacuum core biopsy were classified within the BI-RADS categories. The correlation between BI-RADS assessment categories 3, 4, and 5 and the final histological results was statistically evaluated with the chi2 test. The diagnostic indices were calculated.


RESULTS
The prospectively classified BI-RADS 3/4/5 findings revealed a malignant histology in 5.9%/17.6%/90.9% of all lesions, respectively. The relationship between BIRADS categories 3, 4, and 5 and histology was statistically highly significant (P<0.0001). The sensitivity, specificity, positive and negative predictive values were 95.7%/21.2%,/37.8%/94.3%, respectively.


CONCLUSIONS
The BI-RADS lexicon describes microcalcifications of the breast and provides diagnostic categories that lead to standardized biopsy recommendations. Nevertheless, how to link description to classification of microcalcifications is still a difficult diagnostic task. The evaluation of microcalcifications as proposed in this article may help to set standards in the clinical routine and in the comparability of scientific data.
Müller-Schimpfle
M
M
Institute of Radiology (RZI), Städtische Kliniken Frankfurt/Main and Höchst (SKFH), Academic Teaching Hospital of the University of Frankfurt/Main, Germany. mms@skfh.de
Wersebe
A
A
Xydeas
T
T
Fischmann
A
A
Vogel
U
U
Fersis
N
N
Claussen
C D
CD
Siegmann
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001941:Breast Diseases / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology*; D002114:Calcinosis / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies