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KMID : 1101820140020010016
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Journal of Breast Disease
2014 Volume.2 No. 1 p.16 ~ p.21
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Clinicopathologic Characteristics of Malignant Nonpalpable Breast Lesions with Microcalcification Compared to the Benign Group
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Kim I-Saac
Kang Bong-Su
Kim Seung-Ki
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Abstract
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Purpose: Screening mammography has enhanced the detection of nonpalpable breast cancer with microcalcification. The purpose of this study is to evaluate differences in the clinicopathologic characteristics of malignant nonpalpable breast lesions with microcalcification.
Methods: From January 2008 to December 2013, a total of 103 patients who had undergone breast excision under mammo-guided localization were evaluated. We retrospectively reviewed the clinical and pathologic data and Breast Imaging Reporting and Data System (BI-RADS) mammography (MMG) and ultrasonography (US) results of these patients. Patients were divided into two groups: benign and malignant, based on the final pathological findings. Student t-test and Fisher exact test were used for the statistical analyses.
Results: Out of the 103 cases, 64 (62%) were benign and 39 (38%) malignant. The mean age and body mass index (BMI) were significantly higher (p=0.003 and p= 0.016, respectively) in the malignant group compared to the benign group. Malignancy was associated menopause and history of thyroid disease (p=0.010 and p=0.007, respectively). The BI-RADS MMG category, but not the US, was increased in the malignant group compared to the benign group (p<0.001). Pathologically, the intermediate nuclear grade of ductal carcinoma in situ (DCIS) was higher than in other types (36%), and majority of patients had stage IA invasive carcinoma (90%). There was no lymphatic and perineural invasion in both the groups. Axillary sentinel node biopsy was performed in 17% and 100% of patients with DCIS and invasive carcinoma, respectively; however, the results were negative. Partial mastectomy was performed in 82% and 72% of DCIS and invasive carcinoma patients, respectively. Over 30% of patients who underwent partial mastectomy had to undergo additional surgery due to inaccurate frozen section analysis. No recurrence was observed in the malignant group during the median 27 months follow-up period.
Conclusion: Malignancy is associated with old age, high BMI, menopause, and history of thyroid disease. Increased BI-RADS MMG category is highly correlated with malignancy. Good prognosis and low recurrence are expected in the malignant group. Improvement in the accuracy of frozen section analysis will decrease the need for additional surgery.
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KEYWORD
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Breast neoplasms, Calcification, Mammography
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