Abstract
BackgroundMammographic microcalcifications are considered early signs of breast cancer (BC). We examined the association between microcalcification clusters and the risk of overall and subtype-specific BC. Furthermore, we studied how mammographic density (MD) influences the association between microcalcification clusters and BC risk.MethodsWe used a prospective cohort (n = 53,273) of Swedish women with comprehensive information on BC risk factors and mammograms. The total number of microcalcification clusters and MD were measured using a computer-aided detection system and the STRATUS method, respectively. Cox regressions and logistic regressions were used to analyse the data.ResultsOverall, 676 women were diagnosed with BC. Women with ≥3 microcalcification clusters had a hazard ratio [HR] of 2.17 (95% confidence interval [CI] = 1.57–3.01) compared to women with no clusters. The estimated risk was more pronounced in premenopausal women (HR = 2.93; 95% CI = 1.67–5.16). For postmenopausal women, microcalcification clusters and MD had a similar influence on BC risk. No interaction was observed between microcalcification clusters and MD. Microcalcification clusters were significantly associated with in situ breast cancer (odds ratio: 2.03; 95% CI = 1.13–3.63).ConclusionsMicrocalcification clusters are an independent risk factor for BC, with a higher estimated risk in premenopausal women. In postmenopausal women, microcalcification clusters have a similar association with BC as baseline MD.
Highlights
Breast microcalcifications are deposits of calcium in the breast tissue and appear as small bright spots on mammograms [1]
Mammographic features and risk of breast cancer Overall, each additional microcalcification cluster was associated with 20% increased risk of breast cancer in all women (hazard ratio (HR = 1.20; 95% confidence intervals (CIs) = 1.13–1.28)) (Table 2)
Women with ≥3 microcalcification clusters had an overall 2-fold increased risk of breast cancer compared to women with no clusters (hazard ratio (HR = 2.17; 95% CI = 1.57–3.01)), after adjusting for potential confounders (Table 2)
Summary
Breast microcalcifications are deposits of calcium in the breast tissue and appear as small bright spots on mammograms [1]. Microcalcifications play a crucial role in breast cancer screening, so for the non-palpable breast cancers [2], and are present in approximately one-third of all malignant lesions detected at screening mammography [3, 4]. They are more commonly found in ductal carcinoma in situ [3] than in invasive breast cancers [5]. We studied how mammographic density (MD) influences the association between microcalcification clusters and BC risk. Microcalcification clusters and MD had a similar influence on BC risk.
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