Concordance of mammographic classifications of microcalcifications in breast cancer diagnosis

Cosar, Zehra Sumru; Çetin, Meltem; Tepe, Tuba Kizil; Çetin, Recep; Zaralı, Aliye Ceylan

doi:10.1016/j.clinimag.2005.05.002

Cited by 17 publications

(20 citation statements)

References 13 publications

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“…With respect to MCs, a greater association of malignancy was observed in the presence of pleomorphic and grouped MCs, whereas amorphous MCs presented low probability of malignancy. Such information was in accordance with results found by other authors [28][29][30] . In conclusion, the present study showed there was a prevalence of symptomatic women, with mammographic presentation of spiculated nodules and histological type of IDC.…”

Section: Variables Palpable Nodulesupporting

confidence: 83%

Clinical, mammographic and histopathological correlation of breast cancer in women aged between 50 and 70 years

Vieira¹,

Álvares²,

Almeida³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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Objetivo: Correlacionar os achados clínicos, mamográficos e histopatológicos de mulheres na faixa etária entre 50 e 70 anos que tiveram diagnóstico de câncer mamário e foram atendidas, entre 1998 e 2013, no Ambulatório de Mastologia do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas (CAISM-Unicamp). Métodos: Trata-se de um estudo de corte transversal e retrospectivo, no qual foram analisados os prontuários e as mamografias de 160 mulheres, tamanho amostral suficiente para a análise estatística. As variáveis usadas para comparação foram os achados clínicos, mamográficos e histopatológicos, analisados por meio da estatística descritiva e associativa. Resultados: Entre os 160 casos analisados, 76,9% eram sintomáticos e os principais achados clínicos incluíram nódulo palpável (68,1%) e alterações de pele (30%). As apresentações mamográficas prevalentes nas mulheres assintomáticas foram microcalcificações (48,7%), nódulos (43,2%) e distorção arquitetural (8,1%). Com relação ao tipo histológico, 81,3% apresentaram carcinoma ductal invasivo (CDI) e 10,7%, carcinoma ductal in situ (CDIS). Conclusão: O presente trabalho evidenciou que houve uma predominância de mulheres sintomáticas, com apresentação mamográfica de nódulos espiculados e tipo histológico de CDI. Já nas demais pacientes com lesões detectadas no exame de rastreamento predominaram as microcalcificações pleomórficas como o principal achado do CDIS. A mamografia diagnóstica foi a principal forma de detecção do câncer mamário, podendo representar a falta de acesso dessas mulheres aos exames de rastreamento ou à não detecção precoce das lesões malignas, o que revela a necessidade de melhorar as ações de controle e os protocolos de atendimento dessas pacientes. PALAVRAS-CHAVE:Câncer mamário; mulheres; mamografia; histologia; diagnóstico.Study carried out at the Center for Full Attention to Women's Health in Universidade Estadual de Campinas -Campinas (SP), Brazil. Methods: This was a cross-sectional and retrospective study, in which the medical records and mammograms of 160 women were analyzed, a sufficient sample size for the statistical analysis. The variables used for comparison were the clinical, mammographic and histopathological findings, analyzed through descriptive and associative statistics. Results: Of the 160 cases analyzed, 76.9% were symptomatic, and the main clinical findings included palpable nodule (68.1%) and skin alterations (30%). The prevalent mammographic presentations in asymptomatic women were microcalcifications (48.7%), nodules (43.2%) and architectural distortion (8.1%). Regarding the histological type, 81.3% presented invasive ductal carcinoma (IDC) and 10.7%, ductal carcinoma in situ (DCIS). Conclusion: The present study showed that there was a predominance of symptomatic women with mammographic presentation of spiculated nodules and histological type of IDC. In the other patients with lesions detected in the screening test, pleomorphic microcalcifications were prevalent as the main finding of DCIS. Di...

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Section: Variables Palpable Nodulesupporting

confidence: 83%

Clinical, mammographic and histopathological correlation of breast cancer in women aged between 50 and 70 years

Vieira¹,

Álvares²,

Almeida³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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“…Using the BI-RADS lexicon 4th edition, 24 some authors have evaluated the interobserver variability in, respectively, 83 and 94 breast lesions with calcifications. 18,19 The overall diagnostic agreement was low 19 to moderate 18 but improved in the BI-RADS5 category 18,19 and with experienced readers. 20 Conclusions for the Management of Patients According to the Number of Pejorative Criteria and the Type of Atypia…”

Section: Interobserver Reproducibility In the Classification Of Radiomentioning

confidence: 91%

“…Among B3 lesions, there were 147 atypical ductal hyperplasia and 27 lobular neoplasia including lobular carcinoma in situ with, respectively, 49 and 8 cancers at excision. One reason why previous results must be interpreted with caution, and which potentially explains the discrepancies in results observed, is that interobserver reproducibility in the classification of radiological lesions remains at present low 18 to moderate, 19 especially for non-experienced readers 20 and it is the same for histological lesions 21 since distinguishing between flat epithelial atypia and atypical ductal hyperplasia is sometimes difficult using the WHO criteria. 22 Furthermore, the distinction between atypical ductal hyperplasia and low-grade ductal carcinoma in situ on a core biopsy specimen is uncertain since the extent of atypia cannot be accurately assessed.…”

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confidence: 96%

All atypia diagnosed at stereotactic vacuum-assisted breast biopsy do not need surgical excision

et al. 2011

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The necessity of excision is debatable when atypia are diagnosed at stereotactic vacuum-assisted breast biopsy (microbiopsy). Among the 287 surgical excisions performed at Institut Bergonié from 1999 to 2009, we selected a case-control study group of 151 excisions; 52 involving all the diagnosed cancers and 99 randomly selected among the 235 excisions without cancer, following atypical microbiopsy (24 flat epithelial atypia; 50 atypical ductal hyperplasia; 14 lobular neoplasia; 63 mixed lesions). Mammographical calcification (type, extension, complete removal) and histological criteria of epithelial atypia (type, number of foci, size/extension), topography and microcalcification extension at microbiopsy were compared according to the presence or absence of cancer at excision. Factors associated with cancer at excision were Breast Imaging Reporting and Data System (BI-RADS5) lesions, large and/or multiple foci of mammographical calcifications, histological type, number, size and extension of atypical foci. Flat epithelial atypia alone was never associated with cancer at excision. BI-RADS5, atypical ductal hyperplasia (alone or predominant) and 43 foci of atypia were identified as independent pejorative factors. There was never any cancer at excision when these pejorative factors were absent (n ¼ 31). Presence of one (n ¼ 59), two (n ¼ 23) or three (n ¼ 14) factors was associated with cancer in 24, 15 and 13 cases with an odds ratio ¼ 5.8 (95% CI: 3-11.2) for each additional factor. We recommend that mammographical data and histological characteristics be taken into account in the decision-making process after diagnosis of atypia on microbiopsy. With experienced senologists and strict histological criteria, some patients could be spared surgery resulting in significant patient, financial and time advantages.

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“…Most of the cases had been classified as BIRADS 4a, in a few cases 4b and in no case 4c. The subdivision of the class BIRADS 4 into subcategories, introduced in the fourth edition [7], improves the accuracy in the classification of the likelihood of malignancy [16], but with regard to less suspicious lesions, such as those classifiable as 4a, mammographic abnormalities classified as BIRADS 3 could be included in this group due to their greater variability and lesser concordance among observers as shown in previous studies [17,18]. Consequently, the malignancy associated with lesions classified as B3 may be more variable and tends to be lower.…”

Section: Discussionmentioning

confidence: 99%

Mammotome® and EnCor®: comparison of two systems for stereotactic vacuum-assisted core biopsy in the characterisation of suspicious mammographic microcalcifications alone

et al. 2014

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the lesions. The two systems did not differ statistically for correlation with the final histology (S1 k = 0.94 ± 0.06; S2 k = 0.92 ± 0.08) and underestimation of B3 lesions or in situ (S1 4.5 %; S2 4.3 %). Sensitivity, specificity, PPV, NPV, diagnostic accuracy of S1 and S2 were also not statistically different. The systems differed only in sampling time (S1 80; S2 63 s), but not in total procedure time. Conclusions Our study confirms the effectiveness of VABB in the assessment of microcalcifications and highlights the lack of significant differences between the two systems in terms of diagnostic performance.

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Concordance of mammographic classifications of microcalcifications in breast cancer diagnosis

Cited by 17 publications

References 13 publications

Clinical, mammographic and histopathological correlation of breast cancer in women aged between 50 and 70 years

Clinical, mammographic and histopathological correlation of breast cancer in women aged between 50 and 70 years

All atypia diagnosed at stereotactic vacuum-assisted breast biopsy do not need surgical excision

Mammotome® and EnCor®: comparison of two systems for stereotactic vacuum-assisted core biopsy in the characterisation of suspicious mammographic microcalcifications alone

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