title: Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors.
abstract: OBJECTIVE
  To determine the malignancy rate overall and for specific BI-RADS descriptors in women ≥70 years who undergo stereotactic biopsy for calcifications.
  
  
  METHODS
  We retrospectively reviewed 14,577 consecutive mammogram reports in 6839 women ≥70 years to collect 231 stereotactic biopsies of calcifications in 215 women. Cases with missing images or histopathology and calcifications associated with masses, distortion, or asymmetries were excluded. Three breast radiologists determined BI-RADS descriptors by majority. Histology, hormone receptor status, and lymph node status were correlated with BI-RADS descriptors.
  
  
  RESULTS
  There were 131 (57 %) benign, 22 (10 %) atypia/lobular carcinomas in situ, 55 (24 %) ductal carcinomas in situ (DCIS), and 23 (10 %) invasive diagnoses. Twenty-seven (51 %) DCIS cases were high-grade. Five (22 %) invasive cases were high-grade, two (9 %) were triple-negative, and three (12 %) were node-positive. Malignancy was found in 49 % (50/103) of fine pleomorphic, 50 % (14/28) of fine linear, 25 % (10/40) of amorphous, 20 % (3/15) of round, 3 % (1/36) of coarse heterogeneous, and 0 % (0/9) of dystrophic calcifications.
  
  
  CONCLUSIONS
  Among women ≥70 years that underwent stereotactic biopsy for calcifications only, we observed a high rate of malignancy. Additionally, coarse heterogeneous calcifications may warrant a probable benign designation.
  
  
  CONCLUSIONS
  • Cancer rates of biopsied calcifications in women ≥70 years are high • Radiologists should not dismiss suspicious calcifications in older women • Coarse heterogeneous calcifications may warrant a probable benign designation.
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC, USA. lars.grimm@duke.edu.
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Grimm
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: David Y
authors.initials: DY
authors.lastname: Johnson
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Johnson
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Jay A
authors.initials: JA
authors.lastname: Baker
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Mary Scott
authors.initials: MS
authors.lastname: Soo
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: E Shelley
authors.initials: ES
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Sujata V
authors.initials: SV
authors.lastname: Ghate
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D001940:Breast / Q000473:pathology*; D000071960:Breast Carcinoma In Situ / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D002114:Calcinosis / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D018275:Carcinoma, Lobular / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000379:methods; D012189:Retrospective Studies
keywords: Calcifications; Carcinoma, ductal, breast; Carcinoma, intraductal noninfiltrating; Mammography; Stereotactic techniques