title: BI-RADS 3-5 microcalcifications can preoperatively predict breast cancer HER2 and Luminal a molecular subtype.
abstract: OBJECTIVE
  To investigate associations between breast cancer molecular subtype and the patterns of mammographically detected calcifications.
  
  
  RESULTS
  Identified were 93 (19.1%) Luminal A, 242 (49.9%) Luminal B, 108 (22.2%) HER2 and 42 (8.7%) basal subtypes. In univariate analysis, the clinicopathological parameters and BI-RADS 3-5 microcalcifications, which consisted 9 selected features was significantly associated with breast cancer molecular subtype (all P < 0.05). Among subtypes, multivariate analysis showed that calcification >2 cm in range (OR: 1.878, 95% CI: 1.150 to 3.067) and calcification > 0.5 mm in diameter (OR:2.206, 95% CI: 1.235 to 3.323) was independently predictive of HER2 subtype. The model showed good discrimination for predicting HER2 subtype, with a C-index of 0.704. In addition, multivariate analysis showed that calcification morphology (amorphour or coarse heterogenous calcifications OR: 2.847, 95% CI: 1.526 to 5.312) was independently predictive of Luminal A subtype. The model showed good discrimination for predicting Luminal A subtype, with a C-index of 0.74. And we demonstrated that amorphour or coarse heterogenous calcifications were associated with a higher incidence of Luminal A subtype than pleomorphic or fine linear or branching calcifications. There was no significant difference between breast cancer subtypes (Luminal B vs. other; Basal vs. other) and the patterns of mammographically detected calcifications.
  
  
  METHODS
  Mammographic images of 485 female patients were included. The correlation between mammographic imaging features and breast cancer subtype was analyzed using Chi-square test, univariate and binary logistic regression analysis.
  
  
  CONCLUSIONS
  This study shows that BI-RADS 3-5 microcalcifications can be conveniently used to facilitate the preoperative prediction of HER2 and Luminal A molecular subtype in patients with infiltrating ductal carcinoma.
authors.affiliation: Department of Radiation Oncology and Department of Nuclear Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, People's Republic of China.
authors.forename: DongZhi
authors.initials: D
authors.lastname: Cen
authors.affiliation: Guangdong Provincial Traditional Chinese Medicine Hospital, Guangzhou, Guangdong Province 510120, P.R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.affiliation: Guangdong Provincial Traditional Chinese Medicine Hospital, Guangzhou, Guangdong Province 510120, P.R. China.
authors.forename: Ningna
authors.initials: N
authors.lastname: Li
authors.affiliation: Guangdong Provincial Traditional Chinese Medicine Hospital, Guangzhou, Guangdong Province 510120, P.R. China.
authors.forename: Zhiguang
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Guangdong Provincial Traditional Chinese Medicine Hospital, Guangzhou, Guangdong Province 510120, P.R. China.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Guangdong Provincial Traditional Chinese Medicine Hospital, Guangzhou, Guangdong Province 510120, P.R. China.
authors.forename: Shuqin
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Guangdong Provincial Traditional Chinese Medicine Hospital, Guangzhou, Guangdong Province 510120, P.R. China.
authors.forename: Biao
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province 510080, People's Republic of China.
authors.forename: Chun Ling
authors.initials: CL
authors.lastname: Liu
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province 510080, People's Republic of China.
authors.forename: Zaiyi
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Ultrasound, The Third People's Hospital of Shenzhen, Guangdong Shenzhen 518112, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Luo
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D002114:Calcinosis / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000473:pathology*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008327:Mammography; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: breast cancer molecular subtype; calcification; infiltrating ductal carcinoma; logistic regression; mammography