Malignant calcification is an important unfavorable prognostic factor in primary invasive breast cancer.
OBJECTIVE
To explore the clinical characteristics and prognostic value of malignant calcification in operable breast cancer.


METHODS
A total of 721 patients with invasive ductal carcinoma were divided into two groups based on whether malignant calcifications were observed on mammograms. The association of calcification with pathological features and survival were evaluated. The relative importance of each of the potential prognostic variables was tested using a Cox regression analysis.


RESULTS
Compared with tumors without calcification, those with calcification had a larger tumor size, more lymph node involvement, lower estrogen and progesterone receptor expression and higher human epithelial growth factor receptor 2 expression. The 8-year relapse-free survival was lower for patients with calcifications than for those without (77.5 vs 89.2%, P < 0.01). The 8-year overall survival for patients with calcifications was 82.2% compared with 91.9% for those without (P < 0.01). In multivariate analysis, node status, existence of calcification and tumor size were demonstrated to have a prognostic value for relapse-free survival. The node status, existence of calcifications and estrogen receptor status were also prognostic factors for overall survival.


CONCLUSIONS
Mammographic calcification is a poor prognostic factor for patients with invasive ductal carcinoma. Its prognostic value is second only to axillary node status and greater than the other factors evaluated. Thus, breast cancers with calcifications should be regarded as high risk when determining adjuvant treatment.
Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Hong
H
Ling
Zhe-Bin
ZB
Liu
Ling-Hui
LH
Xu
Xiao-Li
XL
Xu
Guang-Yu
GY
Liu
Zhi-Min
ZM
Shao
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002114:Calcinosis / Q000175:diagnosis* / Q000209:etiology; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008175:Lung Neoplasms / Q000150:complications / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate