RSS-Feed abonnieren
PDF herunterladen
DOI: 10.1055/s-0045-1809161
Malignancy Risk Stratification of Suspicious Breast Microcalcifications Detected on Mammograms Using Morphological and Distribution Characteristics Based on the Fifth Edition of BI-RADS
Funding None.
Abstract
Background
Breast cancer is a major cause of mortality and morbidity in women. Hence, detecting suspicious microcalcifications on mammograms can be crucial for early diagnosis.
Aims
To determine the malignancy risk of suspicious microcalcifications detected on mammograms in terms of positive predictive value (PPV) based on morphology and distribution characteristics and correlate results with BI-RADS Atlas, fifth edition and world literature.
Materials and Methods
This is a hospital-based observational study conducted at our institute over 15-month duration and included all symptomatic and asymptomatic females who underwent mammogram, detected with suspicious breast microcalcifications, followed by stereotactic or ultrasound-guided breast biopsy and histopathology.
Statistical Analysis
The chi-square test was used to test the association of the outcome. A p < 0.05 was considered to be statistically significant.
Results
Among 77 lesions, 56 were not associated with mass and 21 were associated with mass. Overall PPV for malignancy of suspicious microcalcifications not associated with mass was 37.5%, and PPV of these according to morphology descriptors was: amorphous 9.5%; coarse heterogeneous 45.4%; fine pleomorphic 50%, and fine linear/fine linear branching 100% (p < 0.001). Overall PPV when associated with mass was 71.4%. PPV of suspicious microcalcifications for distribution descriptors was: regional 0%, grouped 38.9%, linear 66.7%, and segmental 63.2%.
Conclusion
Results of our study correlated well with BI-RADS, fifth edition. Subcategorizing morphology and distribution descriptors provides accurate risk stratification, determines the need for image-guided biopsy, and guides further management strategies.
Patients' Consent
Consent has been taken from all the patients.
Publikationsverlauf
Artikel online veröffentlicht:
27. Mai 2025
© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Ayyildiz VA, Taydas O, Demirkazik FB, Akpinar MG. Vacuum-assisted breast biopsy of microcalcifications on the stereotactic prone table and comparison of the histopathologic diagnosis with mammographic features. Ann Med Res 2021; 28 (04) 668-673
- 2 Nalawade YV. Evaluation of breast calcifications. Indian J Radiol Imaging 2009; 19 (04) 282-286
- 3 Kim SY, Kim HY, Kim EK, Kim MJ, Moon HJ, Yoon JH. Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS. Ann Surg Oncol 2015; 22 (09) 2895-2901
- 4 Liu J, Huang L. Image-guided vacuum-assisted breast biopsy in the diagnosis of breast microcalcifications. J Int Med Res 2018; 46 (07) 2743-2753
- 5 Hernández PA, Estrada TT, Pizarro AL, Cisternas MD, Tapia CS. Breast calcifications: description and classification according to BI-RADS 5th edition. Rev Chil Radiol 2016; 22: 80-91
- 6 Rao AA, Feneis J, Lalonde C, Ojeda-Fournier H. A pictorial review of changes in the BI-RADS fifth edition. Radiographics 2016; 36 (03) 623-639
- 7 Atlas AB. Breast imaging reporting and data system. American College of Radiology 2013
- 8 Sickles EA, D'Orsi CJ, Bassett LW. et al. ACR BI-RADS mammography. 5th ed.. In: D'Orsi CJ, Sickles EA, Mendelson EB. et al. ACR BI-RADS Atlas, Breast Imaging Reporting and Data System. Reston, VA: American College of Radiology; 2013
- 9 Park GE, Kim SH, Lee JM, Kang BJ, Chae BJ. Comparison of Positive Predictive Values of Categorization of Suspicious Calcifications Using the 4th and 5th Editions of BI-RADS. AJR Am J Roentgenol 2019; 213 (03) 710-715
- 10 Metaxa L, Healy NA, O'Keeffe SA. Breast microcalcifications: the UK RCR 5-point breast imaging system or BI-RADS; which is the better predictor of malignancy?. Br J Radiol 2019; 92 (1103): 20190177
- 11 Burnside ES, Ochsner JE, Fowler KJ. et al. Use of microcalcification descriptors in BIRADS 4th edition to stratify risk of malignancy. Radiology 2007; 242: 388-395
- 12 Soo MS, Baker JA, Rosen EL. Sonographic detection and sonographically guided biopsy of breast microcalcifications. American Journal of Roentgenology 2003; 180 (04) 941-8
- 13 Bae S, Yoon JH, Moon HJ, Kim MJ, Kim EK. Breast microcalcifications: diagnostic outcomes according to image-guided biopsy method. Korean J Radiol 2015; 16 (05) 996-1005