Mammographic tumour appearance is related to clinicopathological factors and surrogate molecular breast cancer subtype

Abstract

Mammographic tumour appearance may provide prognostic useful information. For example, spiculation indicates invasiveness, but also better survival compared to tumours with other appearances. We aimed to study the relationship between mammographic tumour appearance and established clinicopathological factors, including surrogate molecular breast cancer subtypes, in the large Malmö Diet and Cancer Study. A total of 1116 women with invasive breast cancer, diagnosed between 1991 and 2014, were included. Mammographic tumour appearance in relation to status for oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2, histological grade, Ki67 and molecular subtype was analysed using various regression models. All models were adjusted for relevant confounders, including breast density, which can affect mammographic appearance. The results consistently showed that spiculated tumours are indicative of favourable characteristics, as they are more likely to be ER and PR positive, and more often exhibit lower histological grade and lower Ki67 expression. Furthermore, spiculated tumours tend to be of luminal A-like subtype, which is associated with a good prognosis. The establishment of associations between mammographic tumour appearance and clinico­pathological factors may aid in characterizing breast cancer at an earlier stage. This could contribute to more individualized breast cancer treatment in the future.

Investigating the prognostic value of mammographic breast density and mammographic tumor appearance in women with invasive breast cancer: The Malmö Diet and cancer study

“…Tumor appearance is associated with histopathological tumor characteristics [ [9] , [10] , [11] , [12] , [13] ]. E.g., spiculation is associated with favorable characteristics, which has been shown by our group [ 14 ] and others [ 11 , 12 , 15 ]. The spiculated tumors are often of molecular Luminal A-subtype, known for carrying the best prognosis [ 14 , 16 ].…”

“…E.g., spiculation is associated with favorable characteristics, which has been shown by our group [ 14 ] and others [ 11 , 12 , 15 ]. The spiculated tumors are often of molecular Luminal A-subtype, known for carrying the best prognosis [ 14 , 16 ]. The better survival rate among women with spiculated tumors [ [16] , [17] , [18] ], and worse for women with certain tumor-associated calcifications have been reported [ 18 , 19 ].…”

True and Missed Interval Cancer in Organized Mammographic Screening: A Retrospective Review Study of Diagnostic and Prior Screening Mammograms

“…Abnormal mammographic findings include two types of lesions; soft-tissue lesions and calcifications, or a combination. To provide consistency in reporting and communication of findings, and to facilitate studies on associations between mammographic findings and other parameters, systems for standardized reporting and lesion terminology seem important (87,93,94).…”

Preliminary study on DCE-MRI radiomics analysis for differentiation of HER2-low and HER2-zero breast cancer

“…Several studies have demonstrated the association between classic imaging modalities like mammography (MG) and ultrasound (US) with the HER2 status in BC patients. For instance, breast density [33] and a spiculated mass [34] on MG have been linked to HER2 status [35]. However, the predictive power of these variables for determining HER2 status is limited.…”