Microcalcifications Detected as an Abnormality on Screening Mammography: Outcomes and Followup over a Five-Year Period

Melissa Craft,Karen M Flegg,Anne M Bicknell,Georges J Hazan

doi:10.1155/2013/458540

Abstract

Objectives. This study reviewed the outcome of women attending a breast screening program recalled for assessment of microcalcifications and examined the incidence of a breast carcinoma detected during the following five years in any of the women who were given a benign diagnosis at assessment. Method. A retrospective study consisted of 235 clients attending an Australian BreastScreen program in 2003, who were recalled for investigation of microcalcifications detected on screening mammography. Records for the following five years were available for 168 women in the benign outcome group including those who did not require biopsy at initial assessment. Results. Malignant disease was detected in 26.0% (n = 146) of the women who underwent biopsy. None of the women in the benign outcome group, with available five-year follow-up records, developed a subsequent breast cancer, arising from the calcifications initially recalled in 2003. Conclusions. This study highlights the effectiveness of an Australian screening program in diagnosing malignancy in women with screen detected microcalcification. This has been achieved by correctly determining 38% (n = 235) of the women as benign without the need for biopsy or early recall. A low rate of open surgical biopsies was performed with no cancer diagnoses missed at the time of initial assessment.

Highlights

The BreastScreen Australia Program screens over 1.5 million women for breast cancer throughout Australia every two years [1]
A total of 235 women recalled for assessment of calcifications categorised with a breast imaging classification 3, 4, or 5 on screening mammogram at BreastScreen ACT & SENSW, in 2003
We examined the significance of calcifications detected on screening mammogram in the diagnosis of breast carcinoma at BreastScreen ACT & SENSW in 2003

Summary

Introduction

The BreastScreen Australia Program screens over 1.5 million women for breast cancer throughout Australia every two years [1]. Screening involves two mammographic views of each breast: craniocaudal and mediolateral oblique. Abnormalities detected on screening mammography are categorised according to the imaging classifications (1–5) recommended by the National Breast Cancer Centre Breast Imaging Report [2]. At BreastScreen ACT & SENSW, a breast imaging classification 1 or 2 on screening mammogram is considered benign and results in the client being placed on recall for routine screening. A breast imaging classification 3, 4, or 5 on screening mammography leads to recall of the client for assessment. Workup at the assessment clinic may include clinical examination, further mammographic views with reassignment of imaging category, ultrasound, fine needle aspirate (FNA), or core needle biopsy (CNB). An open surgical biopsy may be required in some circumstances

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Discussion

Conclusion