Microcalcifications on postoperative mammograms as an indicator of adequacy of tumor excision.

Abstract

Mammograms, including microfocus spot magnification views, were obtained before reexcision of the tumor-ectomy site in 43 women with breast carcinoma. These studies were prospectively evaluated by radiologists experienced in breast imaging. All women had mammographically evident microcalcifications associated with their original tumors. In all, tumor was at or near the margin of resection or the status of margins was unknown, necessitating reexcision of the tumorectomy site. Of 29 women with residual microcalifications, 20 had residual tumor. The positive predictive value of residual microcalcifications was 0.69. The positive predictive value was greatest (0.90) in women with ductal carcinoma in situ, when more than five microcalifications were present. Residual microcalifications not due to carcinoma were secondary to sclerosing adenosis, fat necrosis, and foreign body granuloma. Of the 13 cases in which no residual calcifications were left after tumorectomy, residual tumor was found in four. The negative predictive value of the absence of calcifications for total excision of tumor was 0.64 for all tumor types and was 1.0 for the noncomedo subtype of ductal carcinoma in situ.

Targeting HER-2/neuin Early Breast Cancer Development Using Dendritic Cells with Staged Interleukin-12 Burst Secretion

“…Microcalcifications, formed within areas of high-grade comedonecrosis DCIS and visualized by mammography, can predict the minimum extent of DCIS (actual tumors often extend beyond microcalcifications) with a positive predictive value of 0.9 (18)(19)(20). We used microcalcifications to estimate the extent of disease and confirmed these findings with MRI.…”

Mammography before post-operative radiotherapy in conservatively managed breast cancer patients: is it useful?

“…To our knowledge, no clear recommendation exists regarding post-operative mammography before adjuvant radiotherapy except in cases of tumours containing calcifications, when a mammogram should be obtained after surgery to determine whether all calcifications have been removed [10,11].…”

Postexcision Mammography Is Indicated After Resection of Ductal Carcinoma-In-Situ of the Breast

“…To our knowledge, only three other comparable series provide data that directly address the role of postexcision mammography in the setting of DCIS. The first of these was published in 1993 by Gluck et al 17 The authors reported that 10 of 15 (67%) patients with residual calcifications on postoperative mammogram had residual DCIS at re-excision. Unlike the present study, Gluck's series included only patients with positive or unknown margins in whom re-excision of the tumor site already was planned.…”

“…[5][6][7][8][9][10][11][12][13][14][15][16] There are few data in the literature about the efficacy of postexcision mammography during the initial treatment of patients with DCIS. [17][18][19] The purpose of this study was to assess the yield and impact of postexcision mammography in the treatment of patients with DCIS.…”