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

TL;DR

The study compares suspicious calcifications in breast imaging to distinguish ductal carcinoma in situ from benign conditions, finding specific features that help early diagnosis.

Contribution

The study identifies linear morphology and segmental distribution as significant indicators of ductal carcinoma in situ (DCIS) in suspicious calcifications.

Findings

Linear morphology and segmental distribution of calcifications significantly correlate with DCIS.

Fine linear calcification increases the risk of DCIS with an odds ratio of 51.72.

Calcification descriptors are crucial for early diagnosis of DCIS versus benign breast disease.

Abstract

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.

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

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.

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.

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.

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

Figures