Mammography casting-type calcification and risk of local recurrence in DCIS: analyses from a randomised study.
BACKGROUND
We studied the association between mammographic calcifications and local recurrence in the ipsilateral breast.


METHODS
Case-cohort study within a randomised trial of radiotherapy in breast conservation for ductal cancer in situ of the breast (SweDCIS). We studied mammograms from cases with an ipsilateral breast event (IBE) and from a subcohort randomly sampled at baseline. Lesions were classified as a density without calcifications, architectural distortion, powdery, crushed stone-like or casting-type calcifications.


RESULTS
Calcifications representing necrosis were found predominantly in younger women. Women with crushed stone or casting-type microcalcifications had higher histopathological grade and more extensive disease. The relative risk (RR) of a new IBE comparing those with casting-type calcifications to those without calcifications was 2.10 (95% confidence interval (CI) 0.92-4.80). This risk was confined to in situ recurrences; the RR of an IBE associated with casting-type calcifications on the mammogram adjusted for age and disease extent was 16.4 (95% CI 2.20-140).


CONCLUSIONS
Mammographic appearance of ductal carcinoma in situ of the breast is prognostic for the risk of an in situ IBE and may also be an indicator of responsiveness to RT in younger women.
King's College London, Medical School, Division of Cancer Studies, London SE1 9RT, UK. Lars.holmberg@kcl.ac.uk
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L
Holmberg
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Wong
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Tabár
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Ringberg
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Karlsson
L-G
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Arnesson
K
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Sandelin
H
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Anderson
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Garmo
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Emdin
D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009336:Necrosis / Q000000981:diagnostic imaging; D009362:Neoplasm Metastasis; D011379:Prognosis; D012008:Recurrence; D018570:Risk Assessment