Original Research Mammography of suspicious calcifications among ductal carcinoma in situ and benign breast disease

Wanrudee Lohitvisate, Chidsupang Kaeorat, Amolchaya Kwankua

About the author(s) Wanrudee Lohitvisate, Department of Radiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Chidsupang Kaeorat, Department of Radiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Amolchaya Kwankua, Department of Radiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

Abstract

Background: Most ductal carcinoma in situ (DCIS) lesions manifest early as calcifications, which could be benign or malignant. The classified group of suspicious calcifications among DCIS and benign breast disease is clinically important to early evaluate patient risk factors and plan treatment options.

Objectives: To compare imaging features of suspicious calcifications between DCIS and benign breast disease.

Method: A retrospective study of 101 suspicious calcifications was performed at Thammasat University Hospital from June 2011 to October 2020. The calcifications were surgically excised by mammography-guided wire localisation. The mammographic features of the suspicious calcifications were reviewed according to the fifth edition of the American College of Radiology Breast Imaging-Reporting and Data System lexicon. For comparing between two groups, the student t-test, Fisher’s exact test and Mann-Whitney U test were used for statistical analyses. The logistic regression analysis was calculated for DCIS prediction.

Results: The pathologic results of all 101 suspicious calcifications were DCIS (30 cases) and benign breast disease (71 cases). Linear morphology and segmental distribution correlated significantly with DCIS (p = 0.003 and p = 0.024, respectively). After multivariable analysis, fine linear calcification still significantly elevated the risk of DCIS (odd ratios, 51.72 [95% confidence interval: 2.61, 1022.89], p-value of 0.01), however, the odds of predicting DCIS was not statistically significant different among any distribution.

Conclusion: Ductal carcinoma in situ calcification has contrasting morphology and distribution features compared to benign breast disease. The calcification descriptor is considered an important implement for early diagnosis and distinguishes DCIS from other benign breast conditions.

Contribution: Calcification descriptor is considered an important implement for early diagnosis and distinguishment of DCIS from other benign breast conditions.

Keywords

ductal carcinoma in situ; benign breast disease; microcalcification; mammography; imaging features

Sustainable Development Goal

Goal 4: Quality education

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