Casting-Type Calcifications With Invasion and High-Grade Ductal Carcinoma In Situ

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Abstract
WITH THE increasing use of mammography, breast cancers are being recognized at smaller sizes and earlier stages.1 Overall, patients diagnosed as having breast cancers smaller than 1.0 cm have a low incidence of nodal metastasis and a relative 20-year survival rate in excess of 90%.2 However, a minority of patients with small breast cancers have an outcome similar to those with with much larger cancers. Mammographic characteristics may be able to predict the outcome or pathologic aggressiveness of breast cancer. One mammographic criterion associated with malignancy is casting-type microcalcifications. Tabár et al3 observed that patients with small invasive cancers (1-14 mm) associated with casting-type mammographic microcalcifications had a 20-year survival rate of only 55%. In contrast, the 20-year survival rate for patients with cancers of a similar size and nodal status was 87%, and 95% for cancers smaller than 10 mm, when other patterns of microcalcification were present. The purpose of this study was to determine the outcome of patients with small breast cancers associated with casting-type microcalcifications.