Mammography casting-type calcification and risk of local recurrence in DCIS: analyses from a randomised study

• Published in: British journal of cancer Vol. 108; no. 4; pp. 812 - 819
• Main Authors: HOLMBERG, L, WONG, Y. N. S, TABAR, L, RINGBERG, A, KARLSSON, P, ARNESSON, L.-G, SANDELIN, K, ANDERSON, H, GARMO, H, EMDIN, S
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 05.03.2013
• Subjects: Aged; Biological and medical sciences; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; breast-conserving surgery; Calcification; Calcinosis - complications; Calcinosis - diagnostic imaging; Cancer and Oncology; Cancer och onkologi; Carcinoma, Intraductal, Noninfiltrating - diagnostic imaging; Carcinoma, Intraductal, Noninfiltrating - pathology; Clinical Medicine; Clinical Study; Cohort analysis; Cohort Studies; DCIS; Female; Gynecology. Andrology. Obstetrics; Hospitals; Humans; ipsilateral recurrence; Klinisk medicin; Lumpectomy; Mammary gland diseases; mammographic calcifications; Mammography; Medical and Health Sciences; Medical records; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Middle Aged; Necrosis - diagnostic imaging; Neoplasm Metastasis; Prognosis; Radiation therapy; radiotherapy; randomised trial; Recurrence; Risk Assessment; Surgery; Tumors; Womens health; Sweden; Relapse; Breast disease; Radiodiagnosis; Mammography; Malignant tumor; ipsilateral recurrence; mammographic calcifications; Breast ductal carcinoma in situ; Radiotherapy; Mammary gland diseases; Ipsilateral; Randomization; randomised trial; Cancerology; Conservative surgery; Treatment; breast-conserving surgery; DCIS; Risk factor; Calcification; Clinical trial; Mammary gland; Cancer
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/bjc.2013.26

We studied the association between mammographic calcifications and local recurrence in the ipsilateral breast. Case-cohort study within a randomised trial of radiotherapy in breast conservation for ductal cancer in situ of the breast (SweDCIS). We studied mammograms from cases with an ipsilateral breast event (IBE) and from a subcohort randomly sampled at baseline. Lesions were classified as a density without calcifications, architectural distortion, powdery, crushed stone-like or casting-type calcifications. Calcifications representing necrosis were found predominantly in younger women. Women with crushed stone or casting-type microcalcifications had higher histopathological grade and more extensive disease. The relative risk (RR) of a new IBE comparing those with casting-type calcifications to those without calcifications was 2.10 (95% confidence interval (CI) 0.92-4.80). This risk was confined to in situ recurrences; the RR of an IBE associated with casting-type calcifications on the mammogram adjusted for age and disease extent was 16.4 (95% CI 2.20-140). Mammographic appearance of ductal carcinoma in situ of the breast is prognostic for the risk of an in situ IBE and may also be an indicator of responsiveness to RT in younger women.