Rebner M, Pennes D R, Adler D D, Helvie M A, Lichter A S
Department of Radiology, Taubman Center, Ann Arbor, MI.
Radiology. 1989 Mar;170(3 Pt 1):691-3. doi: 10.1148/radiology.170.3.2492670.
Ten of 152 (7%) consecutive breast cancer patients who underwent excisional biopsy and radiation therapy developed suspect microcalcifications at the biopsy site. All ten patients underwent reexcision. Seventeen other patients developed scattered, coarse, benign macrocalcifications that have remained stable as determined with mammographic follow-up. Of the ten patients who underwent reexcision, six had clusters of calcifications that were benign, and four had malignant calcifications. The morphologic appearance of the microcalcifications was similar in both malignant and benign disease, although the malignant calcifications tended to appear earlier than the benign ones. Three of the four patients with recurrent carcinoma had had calcifications in the original cancer. The mammographic features of the microcalcifications were not specific enough to distinguish recurrent malignancy from benign disease. Unless calcifications that occur in the breast after lumpectomy and radiation therapy have an unequivocally benign appearance (ie, scattered, round, homogeneous-appearing macrocalcifications), they should be viewed with suspicion and subjected to excisional biopsy.
在152例接受切除活检及放射治疗的连续性乳腺癌患者中，有10例（7%）在活检部位出现可疑微钙化。所有10例患者均接受了再次切除。另有17例患者出现散在、粗大的良性大钙化，经乳房X线摄影随访确定其一直保持稳定。在接受再次切除的10例患者中，6例有钙化簇，为良性，4例有恶性钙化。微钙化在恶性和良性疾病中的形态学表现相似，尽管恶性钙化往往比良性钙化出现得更早。4例复发性癌患者中有3例在原癌灶处有钙化。微钙化的乳房X线摄影特征不足以区分复发性恶性肿瘤和良性疾病。除非在乳房肿块切除及放射治疗后乳房出现的钙化具有明确的良性表现（即散在、圆形、外观均匀的大钙化），否则应予以怀疑并进行切除活检。
