Highlights
- •Benign and malignant calcifications can develop in the ipsilateral breast after BCS.
- •PPV of sampled calcifications following BCS for non-calcified primary was 12.8%.
- •PPV of sampled calcifications following BCS for calcified primary was 38.5%.
- •Suspicious calcifications following BCS require biopsy.
Abstract
Objective
The objective of our study was to determine whether, in the digital era, imaging features
of a primary breast tumor can be used to influence the decision to biopsy ipsilateral
breast calcifications that occur following surgery in women treated with breast conservation
surgery (BCS).
Materials and methods
We retrospectively identified women treated with BCS who subsequently developed suspicious
calcifications in the treated breast (BI-RADS 4 or 5) from January 2012 – December
2018. Only cases with histopathological diagnosis by stereotactic or surgical biopsy
were included. Pathology reports were reviewed, and biopsy results were considered
malignant if invasive carcinoma or ductal carcinoma in situ (DCIS) was found. All
other results were considered benign.
Fisher's exact test was done comparing frequencies of malignancy between those patients
whose original tumor had calcifications versus those whose original tumors were not
calcified.
Results
Of 90 women with suspicious calcifications on a post-BCS mammogram, 65 (72.2%) were
biopsy proven benign and 25 (27.8%) were malignant. The original tumor presented without
calcifications in 39 patients (43%), and 51 (57%) had calcifications with or without
associated mass, focal asymmetry, or architectural distortion. New calcifications
were less likely to be malignant if the original tumor presented without calcifications
(5/39; 12.8%) as compared to original tumors with calcifications (20/51; 38.5%) [p-value < 0.05].
Conclusion
New calcifications after BCS are significantly less likely to be malignant if the
original tumor presented without calcifications. However, with a PPV of 12.8%, even
calcifications in a patient with a non-calcified primary tumor require biopsy.
Keywords
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Article Info
Publication History
Published online: January 19, 2021
Accepted:
January 15,
2021
Received in revised form:
December 22,
2020
Received:
October 15,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
