The X-ray features of breast ductal carcinoma in situ and its small invasive foci and correlation between mammographic features and prognostic biologic factors / 中华放射学杂志

ABSTRACT

Objective To retrospectively evaluate the mammographic features of breast ductal carcinoma in situ (DCIS)and DCIS with small invasive foci,and to analyze the correlation between the mammographic findings and the prognostic biologic factors.Methods The mammographic examination was performed in 95 consecutive women with breast DCIS(n = 50)and DCIS with invasive foci(n = 45 ).The prognostic biologic factors including progesterone receptor(PR),C-erbB-2,and p53 were evaluated in 62 of 95 cases.Categorical data were expressed as percentages and analyzed by using the X~2 test,and furthermore the odds ratio was measured.Results(1)Only one abnormality was seen on mammography in 62 patients. Combined two abnormalities on mammography were seen in 26 patients.Mammograms were normal in 7 patients.(2)Calcifications with or without other abnormality were noted in 62 cases.Of them,73% (n =45)had higher probability of malignancy calcifications and the others were intermediate concern calcifications.Clustered calcifications(36 lesions)was the most common distribution,which usually accompanied by another abnormality.And then were segmental(18 lesions)distributed pattern.As far as the shape of mass (n = 22)was concerned,the oval shaped lesion(13 cases)was the most common,and the margin of the mass appeared as ill-defined in 15 eases,microlobulated in 1,circumscribed in 4,and obscured in 2,respectively.Isodensity mass had a higher frequency in this group(12/22,55%).Other non-calcification findings included architecture distortion(7 cases),local asymmetry (15 cases),global asymmetry (5 cases),and solitary dilated duct (3 cases),and most of them accompanied with other signs. (3)For expression profile of the biological factors,significant differences were found among malignant calcification group,intermediate concern calcification group,and non-calcification group. The odds of PR positive for the lesions noted as non-calcification were 11.00 times higher (X~2 =8.571 ,P=0.003 ;95% CI, 1.998—60.572)than the lesions noted as intermediate concern calcifications,and 8.80 times higher (X~2 = 9.748,P=0.002 ;95% CI,2.024—38.253)than the lesions noted as malignant calcifications.The odds of C-erbB-2 positive for the lesions showed as malignant calcifications were 12.35 times higher (X~2=7.353, P=0.007 ;95% CI,1.447—105.443)than the lesions showed as non-calcification,and 5.74 times higher (X~2=4.977,P = 0.026;95% CI,1.110—29.645)than the lesions showed as intermediate concern calcifications.Conclusion The mammographic features of DCIS and DCIS with small invasive foci were characteristic.Mammographic findings could be a prognostic markers,which could provide a possibility for making a treatment plan.