Occult malignant breast lesions in 114 patients: relationship to age and the presence of microcalcifications.

Hermann, Georg; Janus, Cynthia; Schwartz, I S; Papatestas, Angelos E.; Hermann, D G; Rabinowitz, J G

doi:10.1148/radiology.169.2.2845470

Cited by 49 publications

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“…2,3,14,15 In addition to young age, the presence of mammographic calcification has also been associated with higher rates of local recurrence. 16 Because we and others 8,9,11 found that calcifications detected by screening mammography in young patients are more frequently a manifestation of DCIS, the value of mammography in young patients may be increasing. In addition, local recurrence is more frequent with cancers with extensive intraductal carcinoma manifesting as calcifications.…”

Section: Discussionmentioning

confidence: 97%

Mammographic Appearance of Nonpalpable Breast Cancer Reflects Pathologic Characteristics

et al. 2002

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ObjectiveTo study the relationship of mammographic appearance of nonpalpable breast cancer to the pathologic characteristics. Summary Background DataThe mammographic appearance of nonpalpable breast cancer may be associated with pathologic variables having prognostic significance, which could influence clinical management. MethodsThe authors correlated the mammographic appearance and pathologic characteristics of 543 nonpalpable malignancies diagnosed in a single institution between July 1993 and July 1999. Cancers were divided into four groups based on mammographic presentation: mass, calcification, mass with calcification, and architectural distortion. ResultsThe majority of masses (95%), masses with calcifications (68%), and architectural distortions (79%) were due to invasive cancers, whereas the majority of calcifications (68%) were due to ductal carcinoma in situ (DCIS). Among invasive cancers, calcifications were associated with more extensive intraductal carcinoma, more Her2/neu immunoreactivity, and more necrosis of DCIS. Lymphatic invasion was more common in cancers presenting as a mass with calcifications. Sixty-nine percent of DCIS associated with invasive cancers presenting as calcifications were of high grade according to the European Organization for Research and Treatment of Cancer. Calcifications in noninvasive tumors were associated with necrosis in DCIS. Two thirds of cancers presenting as architectural distortion had positive margins (65%) compared with 35% to 37% of other mammographic presentations. Mammographic presentation was not significantly related to tumor differentiation or estrogen or progesterone receptor status. The ratio of invasive to noninvasive malignancies increased progressively with increasing age from 1:1 in patients younger than 50 years of age to 3:1 in patients older than 70 years, whereas the proportion presenting as calcifications declined from 63% in patients younger than 50 years to 26% in patients older than 70 years. ConclusionsMalignancies presenting as calcifications on mammography are most commonly DCIS. When invasive malignancies presented as calcifications, the calcifications were associated with accompanying high-grade DCIS, and the invasive cancers were often Her2/Neu positive. Mammographic masses with calcifications were associated with lymphatic invasion. Excisional biopsy margins were most commonly positive with architectural distortions. The mammographic appearance of nonpalpable malignancies is related to pathologic characteristics with prognostic value, which varies with patient age and influences clinical management.

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Section: Discussionmentioning

confidence: 97%

Mammographic Appearance of Nonpalpable Breast Cancer Reflects Pathologic Characteristics

et al. 2002

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“…Besides, there were statistically differences of calcification performance rate between different age groups. Proved by pathology, microcalcifications revealed by mammography in young patients were more frequently a manifestation of DCIS (Hermann et al, 1988;Papatestas et al, 1990;Evans et al, 1997). Even invasive malignancies presenting as calcifications also associated with extensive intraductal carcinoma (Healey et al, 1989;Schmidt-Ullrich et al, 1993).…”

Section: Discussionmentioning

confidence: 99%

Differences Between Breast Cancer Patients Younger and Older than 40 Years: Mammographic Findings

Wang

Liu

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Objective: To compare the mammogarphic appearance between breast cancer patients aged <40 and ≥40 years. Methods: Needle localization and biopsy of suspicious mammographic lesions identified 1,959 breast carcinomas in a single institution from Jun 2012 to Apr 2013. According to the age, we divided patients into two groups: <40 and ≥40 years old, and analyzed mammographic appearance separately. Results: Young patients had 44.2% foci with calcification, but old patients only had 39.4% (P<0.001). In younger group, the ratios of cases according to mass density were 41.8% or higher, 58.2% equivalent and lower. In older group, the ratios were 55.5 % and 44.5%, respectively. There were statistical differences between high density and others (P<0.05). The ratios of cases according to mass margin were 13.9% circumscribed and microlobulated, 86.1% indistinct and spiculated in the younger group, as compared to 6.5% and 93.5%, respectively, in the older group (P<0.05). Conclusions: Mammographic findings differ between young and old patients with breast cancer, for example regarding mass density, mass margin and microcalcification ratios.

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“…We are aware of only two comparable large, prospective studies-one limited to screening examinations followed by biopsy recommendation and one limited to screening examinations followed by open biopsy in a Singaporean population (5,28). Compared with prior studies limited to biopsied breasts, we enabled more accurate determination of true-versus false-positive results by including outcomes on all findings through Surveillance Epidemiology and End Results linkage (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Most prior studies are retrospective, small, at a single site, and have limited generalizability.…”

Section: Strengthsmentioning

confidence: 99%

“…Investigators in most prior studies have not comprehensively assessed cancer outcomes, for they assessed cancer status only in patients who underwent biopsy, which led to socalled verification bias, and, thus, they less accurately characterized the predictive value of mammographic findings compared with tumor registry linkage (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In addition, most prior studies were single center based, and, thus, they may have yielded nongeneralizable results.…”

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confidence: 99%

Positive Predictive Value of Specific Mammographic Findings according to Reader and Patient Variables

Venkatesan¹,

Chu²,

Kerlikowske³

et al. 2009

Radiology

131

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Purpose:To evaluate the risk of cancer (positive predictive value [PPV]) associated with specific findings (mass, calcifications, architectural distortion, asymmetry) in mammographic examinations with abnormal results, to determine the distribution of these findings in examinations in which the patients received a diagnosis of cancer and examinations in which the patients did not, and to analyze PPV variation according to radiologist and patient factors. Materials and Methods:HIPAA-compliant institutional review board approval was obtained. PPV of mammographic findings was evaluated in a prospective cohort of 10 262 women who underwent 10 641 screening or diagnostic mammographic examinations with abnormal results between January 1998 and December 2002 in the San Francisco Mammography Registry. The cohort was linked with the Surveillance Epidemiology and End Results program to determine cancer status among these women. PPVs were calculated for each finding and were stratified according to patient characteristics, cancer type, and radiologist reader. Results:Cases of breast cancer (n ϭ 1552) were identified (invasive, n ϭ 1287; ductal carcinoma in situ, n ϭ 270); in five, both kinds of breast cancer were recorded. Overall, of the number of interpretations, masses were most frequently noted in 56%, followed by calcifications in 29%, asymmetry in 12%, and architectural distortion in 4%. Masses, calcifications, architectural distortion, and developing asymmetry demonstrated similar PPVs in screening examinations (9.7%, 12.7%, 10.2%, and 7.4%, respectively), whereas one-view-only and focal asymmetry demonstrated lower PPVs (3.6% and 3.7%, respectively) and were a frequent reason for an abnormal result (42%). Overall, one (5%) in 20 invasive cancers was identified with asymmetry, one (6%) in 16 invasive cancers was identified with architectural distortion, one (21%) in five invasive cancers was identified with calcifications, and two (68%) in three invasive cancers were identified with a mass. Conclusion:Five percent of invasive cancers were identified with asymmetry, and asymmetry is more weakly associated with cancer in screening examinations than are mass, calcifications, and architectural distortion.

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Occult malignant breast lesions in 114 patients: relationship to age and the presence of microcalcifications.

Cited by 49 publications

References 0 publications

Mammographic Appearance of Nonpalpable Breast Cancer Reflects Pathologic Characteristics

Mammographic Appearance of Nonpalpable Breast Cancer Reflects Pathologic Characteristics

Differences Between Breast Cancer Patients Younger and Older than 40 Years: Mammographic Findings

Positive Predictive Value of Specific Mammographic Findings according to Reader and Patient Variables

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