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European Radiology

, Volume 27, Issue 6, pp 2275–2281 | Cite as

Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors

  • Lars J. Grimm
  • David Y. Johnson
  • Karen S. Johnson
  • Jay A. Baker
  • Mary Scott Soo
  • E. Shelley Hwang
  • Sujata V. Ghate
Breast

Abstract

Objectives

To determine the malignancy rate overall and for specific BI-RADS descriptors in women ≥70 years who undergo stereotactic biopsy for calcifications.

Methods

We retrospectively reviewed 14,577 consecutive mammogram reports in 6839 women ≥70 years to collect 231 stereotactic biopsies of calcifications in 215 women. Cases with missing images or histopathology and calcifications associated with masses, distortion, or asymmetries were excluded. Three breast radiologists determined BI-RADS descriptors by majority. Histology, hormone receptor status, and lymph node status were correlated with BI-RADS descriptors.

Results

There were 131 (57 %) benign, 22 (10 %) atypia/lobular carcinomas in situ, 55 (24 %) ductal carcinomas in situ (DCIS), and 23 (10 %) invasive diagnoses. Twenty-seven (51 %) DCIS cases were high-grade. Five (22 %) invasive cases were high-grade, two (9 %) were triple-negative, and three (12 %) were node-positive. Malignancy was found in 49 % (50/103) of fine pleomorphic, 50 % (14/28) of fine linear, 25 % (10/40) of amorphous, 20 % (3/15) of round, 3 % (1/36) of coarse heterogeneous, and 0 % (0/9) of dystrophic calcifications.

Conclusions

Among women ≥70 years that underwent stereotactic biopsy for calcifications only, we observed a high rate of malignancy. Additionally, coarse heterogeneous calcifications may warrant a probable benign designation.

Key Points

Cancer rates of biopsied calcifications in women ≥70 years are high

Radiologists should not dismiss suspicious calcifications in older women

Coarse heterogeneous calcifications may warrant a probable benign designation

Keywords

Stereotactic techniques Mammography Carcinoma, ductal, breast Carcinoma, intraductal noninfiltrating Calcifications 

Abbreviations

BI-RADS

breast imaging reporting and data system

DCIS

ductal carcinoma in situ

ER

estrogen receptor

HER2

human epidermal growth factor receptor 2

LCIS

lobular carcinoma in situ

PR

progesterone receptor

USPSTF

United States Preventive Services Task Force

Notes

Acknowledgments

The scientific guarantor of this publication is Lars Grimm. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, cross sectional study, performed at one institution.

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Lars J. Grimm
    • 1
  • David Y. Johnson
    • 1
  • Karen S. Johnson
    • 1
  • Jay A. Baker
    • 1
  • Mary Scott Soo
    • 1
  • E. Shelley Hwang
    • 2
  • Sujata V. Ghate
    • 1
  1. 1.Department of RadiologyDuke University Medical CenterDurhamUSA
  2. 2.Department of SurgeryDuke University Medical CenterDurhamUSA

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