Stomper Paul C, Geradts Joseph, Edge Stephen B, Levine Ellis G
Department of Diagnostic Imaging, Roswell Park Cancer Institute, School of Medicine and Biomedical Sciences, Elm and Carlton Sts., SUNY at Buffalo, NY 14263, USA.
AJR Am J Roentgenol. 2003 Dec;181(6):1679-84. doi: 10.2214/ajr.181.6.1811679.
Our objective was to determine the degree with which mammographic features predict the presence and size of invasive carcinomas associated with malignant mammographic microcalcification lesions without a mass.
Mammographic features were correlated with pathologic features in 304 consecutive breast carcinomas manifested by mammographic calcifications only in a prospective evaluation.
Mammographic calcifications associated with breast carcinoma had the final pathologic diagnoses of pure ductal carcinoma in situ (DCIS) in 65% of patients, DCIS with a focus of invasion in 32%, and invasive carcinoma only in 4%. Invasive foci were more likely associated with mammographic calcification size of 11 mm and greater (40%, 77/194) compared with 1-10 mm (26%, 29/110; p = 0.019). Invasive foci were also more likely associated with linear calcifications (44%, 55/126) compared with granular calcifications (29%, 51/178; p = 0.007). The frequency of invasion did not increase with calcification extents greater than 10 mm. The frequency of invasion ranged from 22% for less than or equal to 5-mm granular calcifications to 45% for linear calcifications of 11 mm and greater. Only 11% of cancers characterized by fine granular calcifications were associated with invasion as compared with 32% of those with coarse and mixed granular calcifications (p = 0.002).
Mammographic calcification features of malignant lesions cannot predict the absence of invasion with greater than 90% predictive value or predict the presence of invasion with greater than 45% predictive value. Increased extent of calcifications greater than 10 mm was not associated with greater likelihood of invasion.
我们的目的是确定乳腺钼靶特征预测与无肿块的恶性乳腺微钙化病变相关的浸润性癌的存在及大小的程度。
在一项前瞻性评估中，对304例仅表现为乳腺钼靶钙化的连续性乳腺癌的钼靶特征与病理特征进行相关性分析。
与乳腺癌相关的乳腺钼靶钙化在最终病理诊断中，65%的患者为单纯导管原位癌（DCIS），32%为伴有浸润灶的DCIS，仅4%为浸润性癌。与1 - 10 mm的钼靶钙化（26%，29/110）相比，浸润灶更可能与大小为11 mm及更大的钼靶钙化相关（40%，77/194；p = 0.019）。与颗粒状钙化（29%，51/178）相比，浸润灶也更可能与线性钙化相关（44%，55/126；p = 0.007）。当钙化范围大于10 mm时，浸润频率并未增加。浸润频率范围从小于或等于5 mm的颗粒状钙化的22%到11 mm及更大的线性钙化的45%。与32%伴有粗大和混合颗粒状钙化的癌症相比，仅11%以细颗粒状钙化为特征的癌症与浸润相关（p = 0.002）。
恶性病变的乳腺钼靶钙化特征无法以大于90%的预测价值预测无浸润情况，也无法以大于45%的预测价值预测浸润情况。大于10 mm的钙化范围增加与更高的浸润可能性无关。
