Diagnostic value of some microcalcifications with suspected malignancy on mammograms

Le Van Thinh1, Nguyen Thu Huong2, Nguyen Tien Phu2, Nguyen Cong Tien3, Pham Minh Thong3,
1 Hanoi Medical University
2 Vinmec International General Hospital
3 Bach Mai Hospital

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Abstract

SUMMARY


Objective: Diagnostic value of some microcalcifications with suspected malignancy on mammograms.
Methods: The study included 60 women with microcalcifications who underwent imaging-guided biopsy between July 2019 and July 2020
at Bach Mai Hospital. Digital mammograms procured before biopsy were
analyzed independently by one breast imaging subspecialists blinded to
biopsy results.
Results:
* Micro-calcification outside of a mass – 30 cases
The overall positive predictive value of biopsies was 40%. The individual morphologic descriptors predicted the risk of malignancy as follows: fine linear/branching, 7 (87.5%) of 8 cases; fine pleomorphic, 4 (25%) of 16 cases; amorphous, 1 (16.7%) of 6 cases và coarse heterogeneous,
0 cases. Fisher’s Exact testing showed statistical significance among morphology descriptors (p < 0.01)
* Microcalcifications in a mass – 30 cases
The overall positive predictive value of biopsies was 96.7%. The individual morphologic descriptors predicted the risk of malignancy as follows:
fine linear/branching, 16 (100%) of 16 cases; fine pleomorphic, 11 (92%) of 12 cases; amorphous 2 (100%) of 2 cases và coarse heterogeneous, 0 cases.
* The positive predictive value for malignancy according to BI-RADS
assessment categories were as follows: category 4B, 21,1%; category 4C,
66,7%; and category 5, 94.3%.
Conclusion: Morphological description and distribution of microcalcifications on mammograms helps classify BI-RADS and assess
the risk of malignancy for each case for diagnosis and treatment monitoring. The positive predictive values for breast cancer increased in order of amorphous, fine pleomophic, and fine linear/ branching microcalcification.

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References

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