Relationship between Full-Field Digital Mammographic Features and Clinicopathologic Characteristics

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OBJECTIVE Different mammographic features are probably predictive of different prognosis. However, ambiguity still exists in understanding the relationship between them. In resent years, digital mammography has been available for clinical use which has led to a revolution in the resolving of images and an increase in early-stage breast cancer detection.Based on the above knowledge, this study was performed to evaluate the relationship between full-field digital mammographic features and clinicopathologic characteristics in breast cancer.METHODS Digital mammograms of 176 patients with pathologically proven breast cancer were reviewed. Also, clinical and pathologic records (histological types and axillary lymph nodes status) were retrospectively examined.RESULTS Most of the patients with a solitary microcalcification were young women under the age of 50(84.4%), but the majority of the patients with microcalcifications complicated by a mass were elderly women. Microcalcifications detected by mammography occurred frequently in ductal carcinoma in situ (28.1%) and in early invasive carcinoma (15.6%). Breast cancers with expression of microcalcifications combined with a spiculate mass had a high metastatic rate of axillary lymph nodes (69.4%). A high metastatic rate of axillary lymph nodes was also found in the patients with solitary worm-like microcalcifications (57.1%), solitary spiculate mass (53.7%) and solitary non-worm-like microcalcifications (44.4%). Simple worm-like microcalcifications accompanied with metastasis of 4 to 9 axillary lymph nodes occurred in 42.9% of the(6/14) cases. The patients with microcalcifications combined by a spiculate mass and with metastasis of 4 to 9 axillary lymph nodes accounted for 27.8% (10/36) of the cases,and those with metastases of 10 and over accounted for 16.7% (6/36).CONCLUSION Solitary microcalcifications occur frequently in young women and are usually associated with early breast cancer. There is a close relationship between worm-like microcalcifications, a spiculate mass and positive metastases of axillary lymph nodes, which are an index of poor prognosis.
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