Comparing conventional and digital mammography in patients with microcalcifications

Abstract

Objective: Microcalcifications are the primary mammographic abnormalities in 40% of nonpalpable breast cancers. The aim of this retrospective study is to compare the diagnostic value of conventional and digital mammography (CMG and DMG) by reviewing the histopathological results of microcalcifications evaluated with stereotactic biopsy together with these two methods. Material and method: The mammography and stereotactic biopsy images and medical records of 464 females who had undergone wire localization for microcalcifications with CMG and DMG between May 2003 and May 2011 were retrospectively evaluated. The histopathology results were compared according to the positive and negative predictive values (PPV and NPV) and the BI-RADS classification. Results: The histopathology was malignant in 57% (120/207) of the microcalcifications detected with CMG and 22.5% (58/257) of those detected with DMG. The malignant pathologies detected on CMG were infiltrative in 55% and in situ in 45%. The malignant pathologies detected on DMG were infiltrative in 43% and in situ in 56.9%. The microcalcifications detected on CMG were distributed as 30 BI-RADS 3 (PPV: 93.3%); 135 BI-RADS 4 (PPV:39%), and 42 BI-RADS 5 (PPV:100%) lesions and the total PPV was 66%. The microcalcifications detected on DMG were distributed as 1 BI-RADS 3 (PPD: 100%), 249 BI-RADS 4 (PPD: 20%), and 7 BI-RADS 5 (PPD:100%) cases and the total PPV was 22%. Conclusion: Detecting microcalcifications, which are not visible on CMG, increases the 'false positivity' rate but the increase in the detection rate of in situ cancers with DMG can be accepted as an advantage of this method