Is There a Correlation between the Presence of a Spiculated Mass on Mammogram and Luminal A Subtype Breast Cancer?
To determine whether the appearance of a spiculated mass on a mammogram is associated with luminal A subtype breast cancer and the factors that may influence the presence or absence of the spiculated mass.



Three hundred seventeen (317) patients who underwent image-guided or surgical biopsy between December 2014 and April 2015 were included in the study. Radiologists conducted retrospective assessments of the presence of spiculated masses according to the criteria of Breast Imaging Reporting and Data System. We used combinations of estrogen receptor (ER), progesterone receptor (PR), human epithelial growth factor receptor 2 (HER2), and Ki67 as surrogate markers to identify molecular subtypes of breast cancer. Pearson chi-square test was employed to measure statistical significance of correlations. Furthermore, we built a bi-variate logistic regression model to quantify the relative contribution of the factors that may influence the presence or absence of the spiculated mass.



Seventy-one percent (71%) of the spiculated masses were classified as luminal A. Masses classified as luminal A were 10.3 times more likely to be presented as spiculated mass on a mammogram than all other subtypes. Patients with low Ki67 index (< 14%) and HER2 negative were most likely to present with a spiculated mass on their mammograms (p<0.001) than others. The hormone receptor status (ER and PR), pathology grade, overall breast composition, were all associated with the presence of a spiculated mass, but with less weight in contribution than Ki67 and HER2.



We observed an association between the luminal A subtype of invasive breast cancer and the presence of a spiculated mass on a mammogram. It is hypothesized that lower Ki67 index and HER2 negativity may be the most significant factors in the presence of a spiculated mass.
Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Song
S
Liu
Department of Organ Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Xiao-Dong
XD
Wu
Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Wen-Jian
WJ
Xu
Breast Center, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Qing
Q
Lin
Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Xue-Jun
XJ
Liu
Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Ying
Y
Li
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D060787:Neoplasm Grading; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies
D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
Breast cancer; Intrinsic subtype; Luminal A; Mammogram; Spiculated mass