Mammographic casting-type calcifications is not a prognostic factor in unifocal small invasive breast cancer : a population-based retrospective cohort study

• BACKGROUND AND OBJECTIVES: The role of mammographic casting-type microcalcifications as a prognostic factor in breast cancer has been debated. We studied the relation between mammographic features and prognosis in a population-based cohort. METHODS: In 515 women with 1-15 mm invasive breast cancer mammograms were re-classified according to Tabar et al. The relation to breast cancer death was studied. RESULTS: During the follow-up (median 155 months) 44 of 515 women died from breast cancer. Twenty-nine of 515 presented with casting-type calcifications and three of these died from breast cancer. The adjusted odds ratio for breast cancer death was 1.6 (0.5-5.8) for patients presenting with casting-type calcifications and 4.8 (1.8-12.7) for crushed stone-like (pleomorphic) calcifications using stellate tumors as a reference group. CONCLUSIONS: Except for patients with crushed stone-like microcalcifications breast cancer survival was excellent, 87-95% after 15 years. Casting-type calcifications were not a statistically significant prognostic factor. Tumors with casting-type calcifications were more often of high grade, hormone receptor negative, and HER2 positive but this was not statistically significant either. However, microcalcifications may be more prevalent in tumors with extensive ductal cancer in situ (DCIS) containing multiple foci of invasive cancer and in this study we only included unifocal cancer.

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