Breast Cancer

, Volume 11, Issue 1, pp 49–54 | Cite as

What is the predictor for invasion in non-palpable breast cancer with microcalcifications?

  • Seiichiro Nishimura
  • Kaoru Takahashi
  • Naoya Gomi
  • Keiichiro Tada
  • Masujiro Makita
  • Takashi Tada
  • Takuji Iwase
  • Masataka Yoshimoto
  • Futoshi Akiyama
  • Goi Sakamoto
  • Fujio Kasumi
Oral Session

Abstract

Purpose

To assess the presence of invasion in non-palpable breast cancer with microcarcifications.

Material and Methods

We investigated 157 patients with non-palpable breast cancer with microcalcifications, who had undergone stereotactic core biopsy or vacuum-assisted breast biopsy and operation at the Cancer Institute Hospital between 1995 and 2001. We investigated the correlation between the area of calcification (maximum range of microcalcifications measured in mm by direct mammograhy), morphology of calcification on mammography, histological subtype of intraductal carcinoma (comedo or non-comedo) and frequency of invasion, and lymph node metastasis. The chi-square test was used in the statistical analysis andp values less than 0.05 were considered statistically significant.

Results

Invasion was observed in 33 of 157 pts (21%), of whom 23 showed minimal invasion, which is less than 0.5 cm in greatest diameter. The risk of invasion was 13% within 10 mm of the microcalcifications (n = 70), 25% from 11 to 30 mm (n = 59), and 32% more than 31 mm from the microcalcifications (n = 28). The risk of invasion was 16% for punctate-round and amorphous type (n = 87) microcalcifications, and 27% for pleomorphic and linear-branching types (n = 70) (p = 0.092). In addition, invasion was found 10% of the time within 10 mm of punctate-round and amorphous type microcalcifications, and 20% of the time at 11 mm or more. On the other hand, invasion was found 15% of the time within 10 mm of pleomorphic and linear-branching type microcalcifications, and 37% of the time at 11 mm or more. In 72 cases of intraductal carcinoma diagnosed by pathological examination, invasion was found in 10 of 31 (32%) comedo type intraductal carcinomas and in 5 of 41 (12%) non-comedo types(p = 0.0379). There were 5 cases (3.2%) with axillary lymph node metastasis, all of which widely extended more than 21 mm from the microcalcifications.

Conclusion

The risk of invasion was 10% within 10 mm of punctate-round and amorphous type microcalcifications, and 37% at more than 11 mm of pleomorphic, linear-branching microcalcifications.

Key words Non-palpable breast cancer Microcalcification Ductal carcinomain situ Invasion Sentinel lymph node 

Abbreviations

BI-RADS

Breast Imaging Reporting and Data System

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1).
    Committee of Mammography guideline: Mammography guideline. Igakushoin, Tokyo, 2001(in Japanese).Google Scholar
  2. 2).
    American College of Radiology (ACR): Breast Imaging Reporting and Data System (BI-RADS) Third Edition. Reston, Va, 1998.Google Scholar
  3. 3).
    Silverstein M, Gierson E, Colburn W, Rosser R, Waisman J, Gamagami P: Axillary lymphadenectomy for intraductal carcinoma of the breast.Surg Gynecol Obstet 172:211–214, 1990.Google Scholar
  4. 4).
    Silverstein M, Waisman J, Gamagami P, Gierson E, Colburn W, Rosser R, Gordon P, Lewinsky B, Fingerhut A: Intraductal carcinoma of the breast (208 cases), clinical factors influencing treatment choice.Cancer 66:102–108, 1990.PubMedCrossRefGoogle Scholar
  5. 5).
    Lagios M, Westdahl P, Margolin R, Rose M: Ductal carcinoma in situ. Relationship of extent of non-invasive disease to the frequency of occult invasion, multicentricity, lymph node metastases and short term treatment failure.Cancer 50:1309–1314, 1982.PubMedCrossRefGoogle Scholar
  6. 6).
    Wahedna Y, Evans AJ, Pinder SE, Ellis IO, Blarney RW, Geraghty JG: Mammographic size of ductal carcinoma in situ does not predict the presence of an invasive focus.Eur J Cancer 37:459–462, 2001.PubMedCrossRefGoogle Scholar
  7. 7).
    Bagnall M.JC, Evans AJ, Wilson ARM, Pinder SE, Denley H, Geraghty JG, Ellis IO: Predicting invasion in mammographically detected microcalcification.Clin Radiology 56:828–832, 2001.CrossRefGoogle Scholar
  8. 8).
    Holland HR, Hendriks JH, Verbeek AL, Mravunac M, Stekhoven JH: Extent, distribution and mammographic /histological correlation of breast ductal carcinoma in situ.Lancet 335:519–522, 1990.PubMedCrossRefGoogle Scholar
  9. 9).
    Stomper P, Connolly J: Ductal carcinoma in situ of the breast: correlation between mammographic calcification and tumour subtype.Am J Roentgenol 159:483–485, 1992.Google Scholar
  10. 10).
    Lieberman L, Dershaw DD, Rosen PP, Giess CS, Cohen MA, Abramson AF, Hann LE: Stereotactic core biopsy of the breast carcinoma: Accuracy at predicting invasion.Radiology 194:379–381, 1995.Google Scholar
  11. 11).
    Page DL, Simpson JF: Pathology of pre-invasive and excellent prognosis breast cancer.Curr Opin Oncol 2:1031–1037, 1990.PubMedCrossRefGoogle Scholar
  12. 12).
    Ichihara S: Natural history and pathology of Noninvasive mammary carcinoma.J Jpn Assoc Breast Cancer Screen 8:147–155, 1999 (in Japanese).Google Scholar
  13. 13).
    Page DL, Dupont WD, Rogers LW, Jensen RA, Schuyler PA: Continued local recurrence of carcinoma 15-25 years after a diagnosis of low grade ductal carcinoma in situ of the breast treated only by biopsy.Cancer 76:1197–1200, 1995.PubMedCrossRefGoogle Scholar
  14. 14).
    Ichihara S, Aoyama H, Matsuyama T, Kubo K, Tamura J: Relationship between the extent of intraductal component and that of invasive component of ductal carcinoma of the breast.Acta Pathol Jpn 39:786–794, 1989.PubMedGoogle Scholar
  15. 15).
    Diaz LK, Wiley EL, Venta LA: Are Malignant Cells Displaced by Large-Gauge Needle Core Biopsy of the Breast?Am J Roentgenol 73:1303–1313, 1999.Google Scholar
  16. 16).
    Chao C, Torosian MH, Boraas MC, Sigurdson ER, Hoffman JP, Eisenberg BL, Fowble B: Local Recurrence of Breast Cancer in the Stereotactic Core Needle Biopsy Site: Case Reports and Review of the Literature.Breast J 7:124–127, 2001.PubMedCrossRefGoogle Scholar
  17. 17).
    Zavotsky J, Hansen N, Brennan MB, Turner RR, Giuliano AE: Lymph node metastasis from ductal carcinoma in situ with microinvasion.Cancer 85:2439–2443, 1999.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2004

Authors and Affiliations

  • Seiichiro Nishimura
    • 1
  • Kaoru Takahashi
    • 1
  • Naoya Gomi
    • 2
  • Keiichiro Tada
    • 1
  • Masujiro Makita
    • 1
  • Takashi Tada
    • 1
  • Takuji Iwase
    • 1
  • Masataka Yoshimoto
    • 1
  • Futoshi Akiyama
    • 3
  • Goi Sakamoto
    • 3
  • Fujio Kasumi
    • 1
  1. 1.Departments of Breast SurgeryCancer Institute HospitalTosnima-ku, TokyoJapan
  2. 2.Departments of RadiologyCancer Institute HospitalJapan
  3. 3.Department of Breast PathologyThe Cancer Institute of Japanese Foundation for Cancer ResearchJapan

Personalised recommendations