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Cancer yield and imaging features of probably benign calcifications at digital magnification view

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Abstract

Objectives

To investigate the malignancy rate of probably benign calcifications assessed by digital magnification view and imaging and clinical features associated with malignancy.

Methods

This retrospective study included consecutive women with digital magnification views assessed as probably benign for calcifications without other associated mammographic findings from March 2009 to January 2014. Initial studies rendering a probably benign assessment were analyzed, with biopsy or 4-year imaging follow-up. Fisher’s exact test and univariable logistic regression were performed. Cancer yields were calculated.

Results

A total of 458 lesions in 422 patients were finally included. The overall cancer yield was 2.2% (10 of 458, invasive cancer [n = 4] and DCIS [n = 6]). Calcification distribution (OR = 23.80, p = .041), calcification morphology (OR = 10.84, p = .005), increased calcifications (OR = 29.40, p = .001), and having a concurrent newly diagnosed breast cancer or high-risk lesion (OR = 10.24, p = .001) were associated with malignancy. Cancer yields did not significantly differ between grouped punctate calcifications vs. calcifications with other features (1.2% [2 of 162] vs. 2.7% [8 of 296], p = .506). The cancer yield was 1.6% (7 of 437) in women without newly diagnosed breast cancer or high-risk lesions.

Conclusion

The cancer yield of probably benign calcifications assessed by digital magnification view was below the 2% threshold for grouped punctate calcifications and for women without newly diagnosed breast cancer or high-risk lesions. Calcification distribution, morphology, increase in calcifications, and the presence of newly diagnosed breast cancer/high-risk lesion were associated with malignancy.

Key Points

• Among 458 probably benign calcifications assessed by digital magnification view, the overall cancer yield was 2.2% (10 of 458).

• The cancer yield was below the 2% threshold for grouped punctate calcifications (1.2%, 2 of 162) and in women without newly diagnosed breast cancer or high-risk lesions (1.6%, 7 of 437).

• Calcification distribution, morphology, increase in calcifications, and the presence of newly diagnosed breast cancer/high-risk lesion were associated with malignancy (all p < .05).

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Abbreviations

ACR:

American College of Radiology

DCIS:

Ductal carcinoma in situ

CI:

Confidence interval

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Acknowledgements

This study was supported by a faculty research grant of Yonsei University College of Medicine for 2019 (6-2019-0178). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding

This study was supported by a faculty research grant of Yonsei University College of Medicine for 2019 (6-2019-0178). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Radiology, Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea

    Minah Lee, Min Jung Kim, Jung Hyun Yoon & Vivian Youngjean Park

  2. Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea

    Si Eun Lee

  3. Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea

    Hye Rim Kim

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  1. Minah Lee
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  4. Min Jung Kim
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Correspondence to Vivian Youngjean Park.

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The scientific guarantor of this publication is Vivian Youngjean Park

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The authors declare no competing interests.

Statistics and biometry

Biostatistics Collaboration Unit of Yonsei University College of Medicine kindly provided statistical advice for this manuscript.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

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• observational

• performed at one institution

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Lee, M., Lee, S.E., Kim, H.R. et al. Cancer yield and imaging features of probably benign calcifications at digital magnification view. Eur Radiol 32, 4909–4918 (2022). https://doi.org/10.1007/s00330-022-08596-8

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  • DOI: https://doi.org/10.1007/s00330-022-08596-8

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