Objective : To improve the mammographic diagnosis of breast carcinoma withmicrocalcifications, the extent of microcalcifications (S) and that of pathologicalcarcinoma (P) were compared using radiographic findings of specimens.
Materials : The materials included 15 cases of breast carcinomas with microcalcifications only, and 14 cases of masses and microcalcifications appearing outside the tumor density on preoperative mammography.
Methods : The relationship between S and P was defined as follows ;
(1) S<P : pathological carcinoma was present in the area within 20mm from the periphery of microcalcifications on the specimen radiogram. (2) S<<P : pathological carcinoma was present in the area more than 20mm from the periphery of microcalcifications on the specimen radiogram. (3) S=P. (4) S>P : the extent of microcalcifications was larger than the pathological extent of the carcinoma.
The distribution of calcifications was classified into three groups; “scattered”, “middle” and “clustered”. The shape of calcifications was classified into two groups; “granular” and “rod/irregular”.
Results : Our results were as follows; 1) in 14 (48%) of the 29 cases, pathological carcinoma was present beyond the extent of microcalcifications (S<P or S<<P). The S=P type accounted for 11 of 29 cases (38%), and the S>P type accounted for 4 of 29 (14%) cases. (i) Among the 15 cases of microcalcifications only, no S>P cases were found. (ii) Among the 14 cases of mass and microcalcifications outside the tumor density, 4 cases (29%) were the S>P type. 2) The distribution of calcifications was “scattered” in 13 (45%), “middle” in 11 (38%), and “clustered” in 5 (17%) cases. (i) Among the 15 cases of microcalcifications only, there were 6 cases of “scattered” (3 of S<P, 2 of S<<P, 1 of S=P, none of S>P), 5 cases of “middle” (1 of S<P, 1 of S<<P, 3 of S=P, none of S>P), and 4 cases of “lustered” (1 of S<<P, 3 of S=P). (ii) Among the 14 cases of mass and microcalcifications outside the tumor density, there were 7 cases of “scattered” (2 of S<P, none of S<<P, 1 of S=P, 4 of S>P), 6 cases of “middle” (3 of S<P, 1 of S<<P, 2 of S=P, none of S>P), and 1 case of “clustered” (1 of S=P). 3) Concerning the shape of calcifications; there were 24 cases (83%) of “granular” and “rod/irregular” calcifications. (i) Among the 15 cases of microcalcifications only, there were 2 cases of “granular” (1 of S<P, 1 of S<<P). (ii) Among the 14 cases of mass and microcalcifications outside the tumor density, there were 3 cases of “granular” (1 of S<P, 2 of S>P).
Conclusion : It is difficult to diagnose the exact extent of breast carcinoma with microcalcifications using mammography, because pathological carcinoma extends beyond the area of microcalcifications. Our specimen radiographic study confirmed the findings in 48 % of total cases. Regarding the relationship between the distribution of microcalcifications and S : P, there was a discrepancy between the carcinomas with microcalcifications only and those with mass and microcalcifications appearing outside the tumor densities.
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