Screen-detected ductal carcinoma in situ found on stereotactic vacuum-assisted biopsy of suspicious microcalcifications without mass: clinical-histological correlation

Abstract

Background Commonly identified on screening mammography breast microcalcifications are the predominant manifestation of ductal carcinoma in situ (DCIS). The aim of this study was to investigate the association between clinico-radiological features and histological findings in patients with screen-detected DCIS.

Material and methods Consecutive 127 patients with pure DCIS found on stereotactic vacuum-assisted biopsy of screen-detected suspicious microcalcifications without mass entered the study. Patient age, type and distribution of microcalcifications, DCIS nuclear grade and the presence of comedonecrosis were investigated. Association between parameters was statistically analysed with P<0.05 as a significance level.

Results Powdery microcalcifications were most often clustered while regional were most common of casting-type (P<0.001). High, intermediate and low NG of DCIS was significantly related to casting-type, crushed stone-like and powdery microcalcifications, respectively (P<0.01). Low and intermediate NG DCIS were the most common in clustered and grouped microcalcifications while high NG DCIS was the most often when regional distribution was observed (P<0.05). Comedonecrosis was significantly more common in high NG DCIS (P<0.01). The association between comedonecrosis and type of microcalcifications was not significant, but with their distribution was close to the significance level (P=0.07). Patient age was not significantly related to imaging or histological findings.

Conclusions The association between pattern of mammographic microcalcifications and histological findings related to more aggressive disease can be helpful in optimal surgery planning in patients with screen-detected DCIS, regarding the extent of breast intervention and consideration of synchronous sentinel node biopsy.

Key words: breast cancer screening, mammographic microcalcifications, ductal carcinoma in situ