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Non‐palpable breast carcinomas: Correlation of mammographically detected malignant‐appearing microcalcifications and molecular prognostic factors
Author(s) -
Karamouzis Michalis V.,
LikakiKaratza Eleni,
Ravazoula Panagiota,
Badra Filitsa A.,
Koukouras Dimitrios,
Tzorakoleftherakis Evagelos,
Papavassiliou Athanasios G.,
Kalofonos Haralambos P.
Publication year - 2002
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.10654
Subject(s) - medicine , mammography , immunohistochemistry , breast cancer , pathology , mammary gland , biopsy , cancer
Abstract Screening mammography has greatly increased the number of non‐palpable breast carcinomas diagnosed in asymptomatic women. Malignant‐appearing microcalcifications represent one of the earliest mammographic findings of non‐palpable breast carcinomas. Many studies have attempted to correlate radiological and histological features of malignant‐appearing microcalcifications. In the present study, we evaluated the association between mammographically detected malignant‐appearing microcalcifications and the expression profile of selected biological markers in non‐palpable breast carcinomas. Two hundred and eighty patients with non‐palpable suspicious breast lesions that were detected during screening mammography were studied. All patients underwent mammographically‐guided needle localization‐excision breast biopsy. Histological examination showed 74 (26.4%) carcinomas of various subtypes. Immunohistochemistry was carried out in 58/74 carcinomas by using a panel of monoclonal and polyclonal antibodies against estrogen receptor (ER), progesterone receptor (PR), HER‐2/neu, Bcl‐2, Bax, Fas and DNA fragmentation factor (DFF). Malignant‐appearing microcalcifications was the major mammographic finding in 45/58 (77%) patients. Nuclear ER positivity (65.5%) and PR positivity (46.5%) of non‐palpable breast carcinomas were statistically correlated with malignant‐appearing microcalcifications ( p < 0.01 and p < 0.05, respectively). Statistically significant associations were also found between malignant‐appearing microcalcifications and HER‐2/neu positivity ( p < 0.01), Bax positivity ( p < 0.01), Fas positivity ( p < 0.05) and DFF positivity ( p < 0.01), whereas no statistical correlation was found with Bcl‐2 positivity ( p > 0.05). Malignant‐appearing microcalcifications detected during screening mammography represent a diagnostic, prognostic and therapeutic challenge. The mammographic/biological associations and their potential implications in the management of women with non‐palpable breast carcinomas are thoroughly discussed. © 2002 Wiley‐Liss, Inc.