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Histopathologic Correlation of Residual Mammographic Microcalcifications After Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

This study was designed to determine the histopathologic correlation at surgery of residual mammographic calcifications in patients after neoadjuvant chemotherapy (NAC) for locally advanced breast cancer (LABC).

Methods

This single-institution, retrospective study was approved by the Institutional Review Board and was Health Insurance Portability and Accountability act compliant. Women with LABC who underwent NAC between January 1, 2004 and December 31, 2008 and had mammography performed before and after NAC available for review were included in this study. The extent of microcalcifications associated with cancer before and after the completion of NAC was correlated with histopathology and biomarker status.

Results

Of 494 patients who met the inclusion criteria, 106 demonstrated microcalcifications on pre-, post-chemotherapy, or both sets of mammograms and were included in this study. Of 106 women, 31 (29 %) had invasive ductal carcinoma (IDC) and 60 (57 %) had both IDC and ductal carcinoma in situ (DCIS). Microcalcifications decreased or remained stable in 76 (72 %) patients after completion of NAC. Correlation of microcalcifications with histopathology after NAC showed that 43 (40.6 %) patients had tumors associated with benign pathology. Of 32 patients with pathologic complete response, calcifications were associated with DCIS in 9 (9 %) and benign findings in 21 (22 %). The proportion of residual malignant calcifications was higher in ER+ versus ER− patients after NAC.

Conclusions

The extent of calcifications on mammography following NAC does not correlate with the extent of residual disease in up to 22 % of women; this information may impact surgical planning in subsets of women with breast cancer.

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Disclosures

No disclosures are declared by any of the authors.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA

    Beatriz E. Adrada MD, Deanna L. Lane MD, Elsa M. Arribas MD & Wei Yang MD

  2. Division of Pathology/Lab Medicine, Department of Pathology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA

    Lei Huo MD & Erika Resetkova MD

Authors
  1. Beatriz E. Adrada MD
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  2. Lei Huo MD
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  3. Deanna L. Lane MD
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  4. Elsa M. Arribas MD
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  5. Erika Resetkova MD
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  6. Wei Yang MD
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Corresponding author

Correspondence to Wei Yang MD.

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Adrada, B.E., Huo, L., Lane, D.L. et al. Histopathologic Correlation of Residual Mammographic Microcalcifications After Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer. Ann Surg Oncol 22, 1111–1117 (2015). https://doi.org/10.1245/s10434-014-4113-8

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  • DOI: https://doi.org/10.1245/s10434-014-4113-8

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