Premium
Patterns of mammographically detected calcifications after breast‐conserving therapy associated with tumor recurrence
Author(s) -
Dershaw D. David,
Giess Catherine S.,
McCormick Beryl,
Borgen Patrick,
Liberman Laura,
Abramson Andrea F.,
Morris Elizabeth
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970401)79:7<1355::aid-cncr13>3.0.co;2-z
Subject(s) - medicine , mammography , breast cancer , radiology , mammary gland , oncology , cancer
BACKGROUND Some authors have suggested that mammographically evident calcifications that would be considered benign in other situations can be due to carcinoma in women who have undergone breast conservation. This study was undertaken to determine if the pattern of calcifications associated with recurrent tumors detected mammographically differs from that observed in carcinomas developing de novo. METHODS Mammograms of 22 cases of local tumor recurrence were retrospectively reviewed, and calcifications associated with recurrence were characterized according to the American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS) classification. RESULTS Tumors were usually associated with ≥ 10 calcifications (77%; 17 of 22 cases). Recurrences commonly contained very suspicious patterns of calcifications with linear forms present in 15 cases (68%) and pleomorphic calcifications present in 17 cases (77%). The distribution of calcifications was usually clustered (73%; 16 of 22 cases) or segmental (18%; 4 of 22 cases). Recurrences were usually obviously malignant (BI‐RADS Category 5), and were characterized as such in 77% of cases. The remainder were indeterminate, requiring biopsy (BI‐RADS Category 4). Recurrent tumors containing calcifications always contained some suspicious forms. Less worrisome types of calcifications were sometimes observed, including punctate calcifications in 36% and coarse calcifications in 14% of cases, but were always associated with more malignant patterns. CONCLUSIONS Local tumor recurrences, when associated with mammographically evident calcifications, usually have a pattern highly suspicious for malignancy, although indeterminate forms can be the only calcifications present. Characteristically benign patterns of calcifications are not observed in recurrent tumors unless they are associated with more suspicious calcifications. Therefore, women without more worrisome patterns need not undergo biopsy because of the presence of these nonworrisome calcifications. Cancer 1997; 79:1355‐61. © 1997 American Cancer Society.