title: Changing patterns of microcalcification on screening mammography for prediction of breast cancer.
abstract: BACKGROUND
  The presence of microcalcification on mammography is one of the earliest signs in breast cancer detection. However, it is difficult to distinguish malignant calcifications from benign calcifications. The aim of this study is to evaluate correlation between changing patterns of microcalcification on screening mammography and malignant breast lesions.
  
  
  METHODS
  Medical records and diagnostic images of 67 women who had previously undergone at least two digital mammograms at least 6 months apart and underwent mammography-guided needle localization and surgical excision between 2011 and 2013 were retrospectively reviewed and analyzed.
  
  
  RESULTS
  Breast cancer was detected in the surgical specimens of 20 patients (29.9 %). Annual change of extent of microcalcification on mammography showed statistically significant correlation with pathologic outcome (P = 0.023). The changing pattern of new appearance or increased extent of microcalcification on mammography had positive predictive value of 54.8 % for breast cancer, and it was a statistically significant predictor for breast cancer (P = 0.012). Shape or number change of microcalcification without increased extent had less accurate predictive value for breast cancer, particularly in women younger than 50 years (P < 0.001).
  
  
  CONCLUSIONS
  This study showed that the pattern of increased extent of microcalcification on screening mammography was a significant predictor for breast cancer. We suggest that mammography-guided needle localization and surgical excision should be considered when increased extent of microcalcification is observed on screening mammography and closed follow-up without pathologic confirmation can be permitted if absence of extension of microcalcification was confirmed in women younger than 50 years.
authors: Department of Surgery, Gachon University Gil Medical Center, 21 Namdong-daero 774-beon-gil, Namdong-gu, Incheon, 405-760, Korea.
authors: Kwan Il
authors: KI
authors: Kim
authors: Department of Surgery, Gachon University Gil Medical Center, 21 Namdong-daero 774-beon-gil, Namdong-gu, Incheon, 405-760, Korea.
authors: Kyung Hee
authors: KH
authors: Lee
authors: Department of Surgery, Gachon University Gil Medical Center, 21 Namdong-daero 774-beon-gil, Namdong-gu, Incheon, 405-760, Korea.
authors: Tae Ryung
authors: TR
authors: Kim
authors: Department of Surgery, Gachon University Gil Medical Center, 21 Namdong-daero 774-beon-gil, Namdong-gu, Incheon, 405-760, Korea.
authors: Yong Soon
authors: YS
authors: Chun
authors: Department of Surgery, Gachon University Gil Medical Center, 21 Namdong-daero 774-beon-gil, Namdong-gu, Incheon, 405-760, Korea.
authors: Tae Hoon
authors: TH
authors: Lee
authors: Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea.
authors: Hye Young
authors: HY
authors: Choi
authors: Department of Surgery, Gachon University Gil Medical Center, 21 Namdong-daero 774-beon-gil, Namdong-gu, Incheon, 405-760, Korea. hgjh@gilhospital.com.
authors: Heung Kyu
authors: HK
authors: Park
mesh_terms: D000328:Adult; D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Breast cancer; Mammography; Microcalcification; Screening