Abstract
This study aimed to determine whether there is an association between mammographic casting-type calcification and other prognostic factors for invasive breast cancer. We also assessed whether casting-type calcification could be an independent prognostic factor. Invasive breast cancer patient information from January 2010 and January 2013 was retrospectively reviewed. The associations between mammographic casting-type calcification and other clinicopathological factors, including tumor size, node status, grade, progesterone receptor (PR) status, estrogen receptor (ER) status, and human epidermal growth factor receptor 2 (HER2) status, were analyzed. The Kaplan–Meier method and a Cox proportional hazards model were used for survival analyses of disease-free survival (DFS) and overall survival (OS). A total of 1155 invasive breast cancer patients who underwent definitive surgery were included, and 136 cases (11.8%) had casting-type calcification on mammography. In multivariate logistic regression, casting-type calcification was significantly associated with axillary node metastasis, ER-negativity, and HER2 overexpression. Casting-type calcification significantly decreased OS and DFS after a median follow-up of 60 months. This result remained after adjusting other prognostic factors in the multivariate analysis. Casting-type calcification is significantly linked to axillary node metastasis, ER-negativity and HER2 overexpression. Casting-type calcification is therefore an independent prognostic factor for breast cancer patients.
Highlights
Mammographic imaging is an essential tool in screening for breast cancer and deriving a diagnosis[1]
The results suggested that casting-type calcification was significantly associated with estrogen receptor (ER)-negativity (OR 1.49, axillary node metastasis, 95% CI 1.03– 2.16, P = 0.035), and human epidermal growth factor receptor 2 (HER2) overexpression
This study suggested that casting-type calcification was an unfavorable prognostic factor (9.19-fold increased mortality for patients with casting-type calcifications)
Summary
Mammographic imaging is an essential tool in screening for breast cancer and deriving a diagnosis[1]. A study recently reported that the presence of casting-type calcifications was associated with a 3.47-fold increased hazard ratio for mortality, after correcting for other prognostic factors[5]. A study that analyzed a large cohort of screening-detected invasive breast cancers showed that the presence of mammographic comedo (casting) calcification did not have an influence on breast-cancer-specific survival[8]. Other studies have reported that breast tumors with casting-type calcifications had an increased rate of HER2 overexpression and ER negativity[9,10]. Several other studies have indicated there are increased rates of lymph node involvement and larger tumor sizes in patients with calcifications[11,12]. We determined whether casting-type calcification could be employed as a reliable prognostic factor for invasive breast cancer
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