title: Breast carcinoma with basal phenotype: mammographic findings.
abstract: OBJECTIVE
  Basal phenotype has been found to be an independent poor prognostic factor for breast cancer. The aim of this study was to assess the mammographic appearance of screening-detected breast carcinoma with the basal phenotype.
  
  
  METHODS
  A series of 1,944 consecutively enrolled patients with operable invasive breast cancer underwent immunohistochemical analysis with cytokeratin 5/6 and cytokeratin 14 markers to identify tumors exhibiting basal phenotype characteristics. Among those patients, 356 women with breast cancer were common to a prospectively collected database of screening-detected cases of breast cancer. The predominant mammographic appearance and any associated features were reported by experienced image readers blinded to phenotype status. A chi-square test was used to assess difference between the mammographic appearances of a group of tumors with the basal phenotype and those of a group with the nonbasal phenotype.
  
  
  RESULTS
  Forty-one (12%) of the screening-detected tumors had basal phenotypic expression, and these were compared with 309 (88%) nonbasal tumors. Basal-phenotype tumors were significantly more likely to manifest as an ill-defined mass (basal phenotype, 25 [61%] of 41 tumors; nonbasal phenotype, 75 [24%] of 309 tumors; p < 0.001) or with comedo calcification (basal phenotype, nine [22%] of 41 tumors; nonbasal phenotype, 30 [10%] of 309 tumors; p = 0.019). Nonbasal-phenotype tumors were more likely to manifest as a spiculated mass (nonbasal phenotype, 150 [49%] of 309 tumors; basal phenotype, eight [20%] of 41 tumors; p < 0.001). The low rate of spiculation in basal tumors was independent of histologic grade.
  
  
  CONCLUSIONS
  Screening-detected breast tumors with a basal phenotype have a mammographic appearance different from that of nonbasal tumors. This finding may explain the good prognostic value of mammographic spiculation reported in previous studies.
authors.affiliation: Nottingham International Breast Education Centre, Nottingham City Hospital, Hucknall Rd., Nottingham NG5 1PB, United Kingdom. angela.luck@uhb.nhs.uk
authors.forename: Angela A
authors.initials: AA
authors.lastname: Luck
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Evans
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: James
authors.forename: Emad A
authors.initials: EA
authors.lastname: Rakha
authors.forename: E Claire
authors.initials: EC
authors.lastname: Paish
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Green
authors.forename: Ian O
authors.initials: IO
authors.lastname: Ellis
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010641:Phenotype; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D014408:Biomarkers, Tumor