Clustering of Breast Microcalcifications on Digital Mammography: Which Parameters?

BackgroundMammographic density (MD) and malignant-appearing microcalcifications (MAMCs) represent the earliest mammographic findings of non-palpable breast carcinomas. Matrix proteoglycans versican and decorin are frequently over-expressed in various malignancies and are differently involved in the progression of cancer. In the present study, we have evaluated the expression of versican and decorin in non-palpable breast carcinomas and their association with high risk mammographic findings and tumor characteristics.MethodsThree hundred and ten patients with non-palpable suspicious breast lesions, detected during screening mammography, were studied. Histological examination was carried out and the expression of decorin, versican, estrogen receptor α (ERα), progesterone receptor (PR) and c-erbB2 (HER-2/neu) was assessed by immunohistochemistry.ResultsHistological examination showed 83 out of 310 (26.8%) carcinomas of various subtypes. Immunohistochemistry was carried out in 62/83 carcinomas. Decorin was accumulated in breast tissues with MD and MAMCs independently of the presence of malignancy. In contrast, versican was significantly increased only in carcinomas with MAMCs (median ± SE: 42.0 ± 9.1) and MD (22.5 ± 10.1) as compared to normal breast tissue with MAMCs (14.0 ± 5.8), MD (11.0 ± 4.4) and normal breast tissue without mammographic findings (10.0 ± 2.0). Elevated levels of versican were correlated with higher tumor grade and invasiveness in carcinomas with MD and MAMCs, whereas increased amounts of decorin were associated with in situ carcinomas in MAMCs. Stromal deposition of both proteoglycans was related to higher expression of ERα and PR in tumor cells only in MAMCs.ConclusionsThe specific accumulation of versican in breast tissue with high MD and MAMCs only in the presence of malignant transformation and its association with the aggressiveness of the tumor suggests its possible use as molecular marker in non-palpable breast carcinomas.

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“…pleomorphic, irregular, fragmented, casting), density (highly variable), distribution (e.g. clustered) and size (highly variable) [36]. …”

Section: Methodsmentioning

confidence: 99%

Versican but not decorin accumulation is related to malignancy in mammographically detected high density and malignant-appearing microcalcifications in non-palpable breast carcinomas

et al. 2011

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“…Various investigators have attempted to distinguish mammographically benign vs . malignant microcalcifications 6. Histologic examination of the areas of microcalcifications is not always adequate in terms of clinical decision making 7.…”

mentioning

confidence: 99%

Non‐palpable breast carcinomas: Correlation of mammographically detected malignant‐appearing microcalcifications and molecular prognostic factors

Karamouzis

Likaki-Karatza

Ravazoula

et al. 2002

Intl Journal of Cancer

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Screening mammography has greatly increased the number of non-palpable breast carcinomas diagnosed in asymptomatic women. Malignant-appearing microcalcifications represent one of the earliest mammographic findings of nonpalpable breast carcinomas. Many studies have attempted to correlate radiological and histological features of malignantappearing microcalcifications. In the present study, we evaluated the association between mammographically detected malignant-appearing microcalcifications and the expression profile of selected biological markers in non-palpable breast carcinomas. Two hundred and eighty patients with non-palpable suspicious breast lesions that were detected during screening mammography were studied. All patients underwent mammographically-guided needle localization-excision breast biopsy. Key words: non-palpable breast carcinoma; microcalcification; estrogen receptor; progesterone receptor; c-erbB-2; cell proliferation; apoptosisBreast carcinoma represents a common disease among Greek women and is considered to be one of the main causes of cancer mortality. In the last decade screening programs have been intensified in Greece, based on 8 randomized breast screening trials that have suggested a contribution of mammographic screening to breast cancer mortality, 1 although debate continues on this issue. 2 The main goal of these programs is the detection of breast carcinomas in an earlier and more curable stage of evolution. 3 Noteworthy is the fact that with the introduction of mammographic screening, the incidence of ductal carcinoma in situ (DCIS) in asymptomatic women has increased to 20 -25% of all screeningdetected breast cancers. 4 It has been estimated that mammographic detection of non-palpable breast carcinomas reflects only 20% of the "total lifetime" of breast cancer. 5 Mammographically-diagnosed non-palpable breast carcinomas are increasingly encountered and constitute a major clinical entity.Non-palpable breast carcinomas form a heterogeneous group of lesions with variable findings and different prognosis. Most are small in size and have infrequent nodal and distant metastases. It is well documented that microcalcifications represent one of the earliest mammographically detectable changes associated with in situ and invasive breast carcinomas in asymptomatic women. Microcalcifications are the primary indication for approximately 50% of the breast biopsies carried out for non-palpable mammographic abnormalities, although they do not always represent malignancy. Various investigators have attempted to distinguish mammographically benign vs. malignant microcalcifications. 6 Histologic examination of the areas of microcalcifications is not always adequate in terms of clinical decision making. 7 New parameters for mammographically detected microcalcifications associated with non-palpable breast carcinomas are desirable.A wide range of prognostic markers have been proposed for non-palpable breast carcinomas. The clinically available markers such as histological type, size, auxiliary node ...

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Non-palpable breast carcinomas: Correlation of mammographically detected malignant-appearing microcalcifications and epidermal growth factor receptor (EGFR) family expression

et al. 2006

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Clustering of Breast Microcalcifications on Digital Mammography: Which Parameters?

Cited by 3 publications

References 4 publications

Versican but not decorin accumulation is related to malignancy in mammographically detected high density and malignant-appearing microcalcifications in non-palpable breast carcinomas

Versican but not decorin accumulation is related to malignancy in mammographically detected high density and malignant-appearing microcalcifications in non-palpable breast carcinomas

Non‐palpable breast carcinomas: Correlation of mammographically detected malignant‐appearing microcalcifications and molecular prognostic factors

Non-palpable breast carcinomas: Correlation of mammographically detected malignant-appearing microcalcifications and epidermal growth factor receptor (EGFR) family expression

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