Evaluation of breast calcif ication, calcif ication characteristics, and BI-RADS categories in patients with primary hyperparathyroidism

TL;DR

This study found no increased risk of breast calcification or cancer in women with primary hyperparathyroidism compared to healthy women.

Contribution

The study is the first to evaluate breast calcification and BI-RADS scores in PHPT patients and their cancer risk.

Findings

PHPT patients had no higher calcification rates or BI-RADS scores than healthy controls.

Breast calcification was negatively correlated with parathyroid hormone and urine calcium levels in PHPT patients.

Only one PHPT patient had breast cancer, suggesting no increased cancer risk despite higher screening frequency.

Abstract

To determine the frequency and types of breast calcif ication, the
distribution of breast imaging-reporting and data system (BI-RADS) scores,
and the association between calcif ication and biochemical/clinical findings
in patients with primary hyperparathyroidism (PHPT).

We recruited ≥ 40-year-old female patients with PHPT (n = 104) and
age-matched healthy women (n = 107) as controls. Mammography was performed
on all participants. Calcif ication, calcif ication type, and BI-RADS scores
were recorded, and patients were divided into two groups based on PHPT
duration and presence/absence of calcification.

BI-RADS score distribution was indifferent between groups. The frequency of
calcification and distribution of calcification types showed no difference
between groups. Likewise, mammography findings were consistent among PHPT
patients regardless of disease duration. There was no cutoff for disease
duration that could predict the presence of calcification. Breast
calcification was negatively correlated with parathyroid hormone (r =
-0.220, p = 0.025) and 24-hour urine calcium levels (r = -0.195, p = 0.048),
and positively correlated with age (r = 0.219, p = 0.025) in PHPT patients.
Of the six patients who underwent cytological examination, one was found to
be malignant (PHPT group).

Female patients with PHPT do not have an increased incidence of breast
calcification or higher BI-RADS scores compared to healthy women, and the
calcification rates were unaffected by the duration of the disease. The
presence of calcification does not appear to be associated with an increased
risk of breast cancer in PHPT patients. Nonetheless, given the frequency of
breast cancer and that the only patient with breast cancer was part of the
PHPT group, it would be appropriate to screen these patients for breast
cancer carefully.

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