Mammographic Microcalcifications and Breast Cancer: A Radio-Pathological Correlation

Abstract

Background: Breast cancer is the most common cancer for women, often asymptomatic, and diagnosed from combined screening using mammography and ultrasound. Abnormal findings include microcalcifications with widely variable positive predictive values (PPVs) for malignancy, ranging from 2% to 95%. PPVs for each type of microcalcification are unknown. Objective: To assess PPVs for all abnormal microcalcifications in Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 as seen by mammography. Materials and Methods: The present study was a retrospective study of 62 female patients with abnormal microcalcifications that underwent mammography-guided needle localized excision between September 2011 and December 2018, at Thammasat University Hospital. Results: Of all 72 abnormal microcalcifications, PPVs were coarse heterogeneous 25%, amorphous 37.93%, fine pleomorphic 42.31%, and fine linear or linear branching 33.33%. Conclusion: Abnormal microcalcifications rated BI-RADS 4 or 5 have greatly varying malignancy risks, thus, tissue biopsies should be considered in line with microcalcification morphology and individual patient risk factors. Keywords: Breast cancer, Mammography, Microcalcification, Radio-pathologic correlation, Needle localized excision