Morphologic Analysis of Microcalcifications

Abstract

Almost 30 years ago, Gershon-Cohen et al. (1955) were the first to report on the mammographic detection of clinically occult carcinomas of the breast. Since then, mammography has come into use all over the world, so that preclinical carcinomas are discovered daily everywhere. In my institute alone, these cases made up 18% of the total of 519 carcinomas diagnosed from 1 October 1974 to 30 June 1983. More than half of these occult carcinomas (n = 50) were diagnosed solely on the basis of microcalcifications; microcalcifications are thus the most important leading symptom in mammographic detection of preclinical carcinomas. All physicians using mammography are naturally concerned to draw therapeutic conclusions from this diagnosis. Only a nonmutilating treatment appropriate to the stage of early cancer can justify the major expenditure entailed by mammography. However, what is the meaning of “early cancer”? No generally valid definition is found in the literature. Even the fact that a carcinoma is clinically occult does not by any means imply that an early cancer is involved, since even relatively large carcinomas can remain clinically occult in large breasts.