Hofvind Solveig, Iversen Barbro F, Eriksen Liv, Styr Bodil M, Kjellevold Kjell, Kurz Kathinka D
Department of Screening Based-Research, Cancer Registry of Norway, Oslo, Norway.
Acta Radiol. 2011 Jun 1;52(5):481-7. doi: 10.1258/ar.2011.100357. Epub 2011 Mar 28.
Ductal carcinoma in situ of the breast (DCIS) represents a challenge in mammographic screening due to its unknown progression into invasive cancer. The majority of the DCIS is detected due to signs of calcifications on the mammograms.
To analyze the combinations of mammographic morphology and distribution of calcifications by Van Nuys nuclear grade (grade).
A total of 217 DCIS diagnosed in women aged 50-69 years old who participated in the Norwegian Breast Cancer Screening Program in the period November 1995 to December 2007 were reviewed by four breast imaging specialists. The mammograms were classified according to the morphology and distribution of the calcifications, using BI-RADS nomenclature. Chi square test was used to compare the groups of morphology and distribution by grade.
Calcifications were identified in 93% (202/217) of the cases, 15% (30/202) as grade 1 and 74% (149/202) as grade 3. Fine pleomorphic calcifications were seen in 38% (77/202) of the lesions and fine linear and fine linear branching in 31% (62/202). Sixty-nine percent (53/77) of the fine pleomorphic and 84% (52/62) of the fine linear and fine linear branching calcifications were high grade lesions. Grouped distribution was seen in about half of all the cases (104/202). Among the high grade lesions with fine pleomorphic or fine linear and fine linear branching calcifications, 75% (40/53) and 69% (36/52), respectively, had grouped or segmental distribution.
DCIS presented overlapping groups of morphology and distribution of calcification by grade, but fine pleomorphic and fine linear and fine linear branching calcifications with grouped and segmental distributions were associated with high grade DCIS. Seeking for further knowledge that allows separation of non-high grade from high grade DCIS has to continue to improve the quality of mammographic screening.
乳腺导管原位癌（DCIS）因其向浸润性癌进展情况不明，给乳腺钼靶筛查带来了挑战。大多数DCIS是因钼靶上的钙化迹象而被检测出。
通过范努伊斯核分级（分级）分析乳腺钼靶形态与钙化分布的组合情况。
对1995年11月至2007年12月期间参加挪威乳腺癌筛查项目的50 - 69岁女性中诊断出的217例DCIS进行回顾，由四位乳腺影像专家进行审查。使用BI-RADS命名法根据钙化的形态和分布对钼靶进行分类。采用卡方检验按分级比较形态和分布组。
93%（202/217）的病例中发现钙化，其中15%（30/202）为1级，74%（149/202）为3级。38%（77/202）的病变可见细多形性钙化，31%（62/202）可见细线性和细线性分支钙化。69%（53/77）的细多形性钙化和84%（52/62）的细线性及细线性分支钙化是高级别病变。约一半的病例（104/202）可见成簇分布。在具有细多形性或细线性及细线性分支钙化的高级别病变中，分别有75%（40/53）和69%（36/52）有成簇或节段性分布。
DCIS按分级呈现出钙化形态和分布的重叠组，但具有成簇和节段性分布的细多形性、细线性及细线性分支钙化与高级别DCIS相关。寻求进一步知识以区分非高级别与高级别DCIS对于持续提高乳腺钼靶筛查质量至关重要。
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