Mammographic extent of microcalcifications and oestrogen receptor expression affect preoperative breast carcinoma in situ size estimation

Jiménez, Marta; Mojal, Sergi; Gamero, Rocío; Bosch-Nicolau, Pau; Rodríguez-Arana, Ana; Plancarte, F.; Corominas, Josep; Serrano-Munne, Laia; Carreras, Ramón; Sabadell, Dolors

doi:10.1007/s12282-016-0729-9

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…Studies published in the last 20 years confirm the controversial nature of the alleged association of HPV with BC. There are reports which favor the impact of HPVs in BC oncogenesis (21,75,78,(80)(81)(82)84,89), while other studies have confirmed a limited or nonexistent role of HPVs in the development of BC (3,7,18,74,76,77,79,83,(85)(86)(87)(88)(90)(91)(92).…”

Section: Discussionmentioning

confidence: 99%

“…The 23 included studies involved a total of 3,243 breast tissue samples, collected between 2004 and 2022 from nine countries worldwide (Table SIV) (3,7,18,21,(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91)(92). A total of six continental regions (Asia, Europe, Oceania, north Africa and South America) were represented.…”

Section: Baseline Characteristics Of the Included Studies And Assessm...mentioning

confidence: 99%

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Human papillomaviruses and breast cancer: A systematic review and meta‑analysis

Karachalios,

Petousis,

Margioula‑Siarkou

et al. 2023

Oncol Lett

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Breast cancer (BC) is the leading malignancy worldwide. The association between human papillomavirus (HPV) and BC is debatable. The present systematic review and meta-analysis aimed to assess the prevalence of HPV DNA in malignant breast tumors. An extensive search of the PubMed and SCOPUS databases was carried out for case-control studies published between January 1, 2003 and January 7, 2023, which compared HPV DNA detection in breast tissue specimens of female patients with BC and women with absent or benign breast disorders. Once the initial title/abstract screening was completed by two independent investigators, the full texts of the included studies from that stage were reviewed by the aforementioned investigators to determine if they should be included in the present study. Data extraction was independently conducted by two investigators. A third investigator was consulted to resolve disagreements through free discussion. MedCalc was used for quantitative synthesis. The significance of association was estimated by pooled odds ratios (ORs) with 95% confidence intervals (CIs) calculated using the random-effects model. A total of 23 primary studies, including 3,243 subjects (2,027 patients and 1,216 controls), were eligible for quantitative analysis. HPV prevalence in patients with BC and controls was 21.95 and 8.96%, respectively. The prevalence of HPV differed significantly between the two groups (OR 3.83; 95% CI 2.03-7.25; P<0.01). Heterogeneity among studies was quantified using the I 2 index which was 69.57% (95% CI 51.89-80.75). The risk of bias was assessed using an appropriate tool contributed by the CLARITY Group at McMaster University. Seven studies had a low risk of bias, 15 studies had a moderate risk of bias and only one study had a serious risk of bias. These results reinforce the hypothesis that HPV is involved in BC development and progression, indicating a possible role of HPV vaccination in BC prevention.

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Section: Discussionmentioning

confidence: 99%

Section: Baseline Characteristics Of the Included Studies And Assessm...mentioning

confidence: 99%

Human papillomaviruses and breast cancer: A systematic review and meta‑analysis

Karachalios,

Petousis,

Margioula‑Siarkou

et al. 2023

Oncol Lett

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“…This method of intraoperative assessment presumes that the location of microcalcifications on radiography is an accurate surrogate for the presence of DCIS at the pathologic specimen margin. However, there is a difference between the mammographic extent of calcifications and the histologic tumor size of DCIS, with frequent underestimation of size on mammography . In addition, not all DCIS is calcified, with low‐grade lesions being less likely to contain microcalcifications .…”

Section: Introductionmentioning

confidence: 99%

Evaluating the relationship between ductal carcinoma in situ, calcifications, and margin status in patients undergoing breast conserving surgery

Bruenderman

Bhutiani

Mercer

et al. 2019

Journal of Surgical Oncology

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Background Microcalcifications associated with ductal carcinoma in situ (DCIS‐AMC) close to lumpectomy margins could be used as a surrogate for margin involvement and aid in decreasing margin re‐excision. We sought to evaluate the histologic factors of DCIS‐AMC near lumpectomy margins. Methods Women with DCIS treated with breast‐conserving surgery (BCS) who had DCIS‐AMC on surgical specimens were identified. Pathology slides were reviewed to determine the distance of DCIS‐AMC from each margin (six per specimen) and the distance of DCIS from each margin (ie, margin status). Results Of 35 patients (210 margins), 24 had close/positive margins (39 margins [18%]). DCIS‐AMC≤10 mm from a margin was associated with a greater incidence of DCIS≤2 mm from the margin (31.7% DCIS‐AMC≤10 mm vs 13.3% no DCIS‐AMC≤10 mm, P = 0.003). On multivariable analysis, DCIS≤2 mm from the margin was independently associated with DCIS‐AMC≤10 mm from the margin (odds ratio 2.95, 95% confidence interval 1.48‐5.86, P = 0.002). Conclusions DCIS‐AMC≤10 mm from the inked margin is associated with DCIS at or close to the margin (≤2 mm). Using this knowledge, intraoperative techniques like specimen radiography could be utilized to detect microcalcifications≤10 mm from a margin and guide selective margin re‐excision in BCS.

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Comparison of Mammography and Ultrasonography for Tumor Size of DCIS of Breast Cancer

Wang

et al. 2019

CMIR

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Objective: Accurate assessment of breast tumor size preoperatively is important for the initial decision-making in surgical approach. Therefore, we aimed to compare efficacy of mammography and ultrasonography in ductal carcinoma in situ (DCIS) of breast cancer. Methods: Preoperative mammography and ultrasonography were performed on 104 women with DCIS of breast cancer. We compared the accuracy of each of the imaging modalities with pathological size by Pearson correlation. For each modality, it was considered concordant if the difference between imaging assessment and pathological measurement is less than 0.5cm. Results: At pathological examination tumor size ranged from 0.4cm to 7.2cm in largest diameter. For mammographically determined size versus pathological size, correlation coefficient of r was 0.786 and for ultrasonography it was 0.651. Grouped by breast composition, in almost entirely fatty and scattered areas of fibroglandular dense breast, correlation coefficient of r was 0.790 for mammography and 0.678 for ultrasonography; in heterogeneously dense and extremely dense breast, correlation coefficient of r was 0.770 for mammography and 0.548 for ultrasonography. In microcalcification positive group, coeffient of r was 0.772 for mammography and 0.570 for ultrasonography. In microcalcification negative group, coeffient of r was 0.806 for mammography and 0.783 for ultrasonography. Conclusion: Mammography was more accurate than ultrasonography in measuring the largest cancer diameter in DCIS of breast cancer. The correlation coefficient improved in the group of almost entirely fatty/ scattered areas of fibroglandular dense breast or in microcalcification negative group.

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Mammographic extent of microcalcifications and oestrogen receptor expression affect preoperative breast carcinoma in situ size estimation

Abstract: Risk of over- or underestimation of DCIS size through MEM measurement depends on DCIS ER expression and MEM itself. Identifying which patients are at a significant risk of over- or underestimation could help the breast surgeon when discussing the surgical options with the patient.

Cited by 4 publications

References 20 publications

Human papillomaviruses and breast cancer: A systematic review and meta‑analysis

Human papillomaviruses and breast cancer: A systematic review and meta‑analysis

Evaluating the relationship between ductal carcinoma in situ, calcifications, and margin status in patients undergoing breast conserving surgery

Comparison of Mammography and Ultrasonography for Tumor Size of DCIS of Breast Cancer

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