Assessment of lesions suspected calcifications in breast cancer patients through mammography and ultrasound images
DOI:
https://doi.org/10.62992/bffacn03Keywords:
Breast cancer, Calcifications, Lesions, Mammography, UltrasoundAbstract
Background: Imaging plays a key role in modern medicine. It helps doctors assess the condition of tumours, thereby effectively supporting diagnosis and providing appropriate treatment regimens.
Objectives: This study aimed to describe some ultrasound and mammography characteristics of suspected calcified breast lesions; and determine the extent of breast lesions according to BIRADS-5 classification.
Methods: A cross-sectional prospective study was conducted with 71 women diagnosed with breast cancer at the Vietnam National Cancer Hospital from August 2022 to August 2023. All participants underwent mammography and breast ultrasound to assess the stage of cancer lesions based on BIRADS-5 criteria and to identify clinically suspected calcified lesions. The data were analysed using descriptive statistics and Chi-square tests, with a significant level set at p-value <0.05.
Results: The study showed that breast tissue density was mainly type C (90.1%), and the most common suspected calcification was polymorphic calcification (45.1%). Lobular distribution was the most common (49.3%) while asymmetric lesions (6.2%) and structural inversion (4.2%) were rare. Mass lesions accounted for the majority (60.6%). The distribution of mass lesions, non-mass lesions, and histopathological types was statistically significant (P=0.001). Malignant lesions often had increased density on mammography (71.8%), decreased echogenicity on ultrasound (60.6%), irregular shape (95.3%), and spiculated edges (53.4%). In addition, most tumours were classified as BIRADS 5 (40.8%), and BIRADS 4C (39.4%), and there was a difference in the proportion of BIRADS classification and histopathological lesion type (P=0.003).
Conclusion: The preliminary results of the study revealed a distinct difference in the imaging features observed in mammography and ultrasound for diagnosing breast lesions. Consequently, utilizing a combination of mammography and ultrasound is essential for accurate BIRADS classification, which in turn facilitates tailored prognosis and treatment plans for each patient.
References
Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L et al (2024). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.who.int/today
Cancer Today (2023). Global cancer observatory: Vietnam. Available from: https://gco.iarc.who.int/media/globocan/factsheets/populations/704-viet-nam-fact-sheet.pdf
Wang X, Chao L, Chen L, et al. Correlation of Mammographic Calcifications with HER-2/neu Overexpression in Primary Breast Carcinomas. J Digit Imaging. 2008;21(2):170-176
Sickles E. Mammographic detectability of breast microcalcifications. American Journal of Roentgenology. 1982;139(5):913-918.
Balu-Maestro C, Chapellier C, Ben Taaritt I, Fournol M. Ultrasound examination of breast microcalcifications: luxury or necessity?. J Radiol. 2006;87(12):1849-1858.
Athanasiou A, Tardivon A, Ollivier L, Thibault F, El Khoury C, Neuenschwander S. How to optimize breast ultrasound. Eur J Radiol. 2008;69(1):6–13.
Nothacker M, Duda V, Hahn M, et al. Early detection of breast cancer: benefits and risks of supplemental breast ultrasound in asymptomatic women with mammographically dense breast tissue. A systematic review. BMC Cancer. 2009;9:335
Youk JH, Kim EK, Kim MJ, Kwak JY, Son EJ. Performance of hand-held whole-breast ultrasound based on BI-RADS in women with mammographically negative dense breast. Eur. Radiol. 2011;21:667–675
Stone N, Matousek P. Advanced transmission Raman spectroscopy: A promising tool for breast disease diagnosis. Cancer Res. 2008;68:4424–4430.
Kim SH, Kim HH, Moon WK. Automated breast ultrasound screening for dense breasts. Korean J Radiol. 2020;21(1):15–24.
Ohuchi N, Suzuki A, Sobue T, Kawai M, Yamamoto S, Zheng Y-F, et al. Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomized controlled trial. Lancet. 2016;387(10016):341–8.
Sickles E, D’Orsi C, Bassett LW, et al. BI-RADS: Mammography. Breast Imaging Reporting and Data System: ACR BI-RADS – Breast Imaging Atlas. 5th ed. Reston, Va: American College of Radiology, 2013.
Arnold M, Morgan E, Rumgay H, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast. 2022;66:15-23
Song QK, Li J, Huang R, et al. Age of diagnosis of breast cancer in china: almost 10 years earlier than in the United States and the European union. Asian Pac J Cancer Prev. 2014;15(22):10021-10025
Cheng SA, Liang LZ, Liang QL, et al. Breast cancer laterality and molecular subtype likely share a common risk factor. Cancer Manag Res. 2018;10:6549-6554
Amer MH. Genetic factors and breast cancer laterality. Cancer Manag Res. 2014;6:191-203
Perkins CI, Hotes J, Kohler BA, Howe HL. Association between breast cancer laterality and tumor location, United States, 1994-1998. Cancer Causes Control. 2004;15(7):637-645
Rummel S, Hueman MT, Costantino N, Shriver CD, Ellsworth RE. Tumour location within the breast: Does tumour site have prognostic ability? Ecancermedicalscience. 2015;9:552
Chan S, Chen JH, Li S, et al. Evaluation of the association between quantitative mammographic density and breast cancer occurred in different quadrants. BMC Cancer. 2017;17:274
Li E, Guida JL, Tian Y, et al. Associations between mammographic density and tumor characteristics in Chinese women with breast cancer. Breast Cancer Res Treat. 2019;177(2):527-53
Sprague BL, Gangnon RE, Burt V, et al. Prevalence of mammographically dense breasts in the United States. J Natl Cancer Inst. 2014;106(10):dju255
Soo MS, Baker JA, Rosen EL. Sonographic Detection and Sonographically Guided Biopsy of Breast Microcalcifications. American Journal of Roentgenology. 2003;180(4):941-948
Lai KC, Slanetz PJ, Eisenberg RL. Linear Breast Calcifications. American Journal of Roentgenology. 2012;199(2):151-157
Gaur S, Dialani V, Slanetz PJ, Eisenberg RL. Architectural Distortion of the Breast. American Journal of Roentgenology. 2013;201(5):662-670
Hanafy M, Ahmed A, Ali E. Mammographically detected asymmetries in the era of artificial intelligence. Egyptian Journal of Radiology and Nuclear Medicine. 2023;54
Leung JWT, Sickles EA. Developing Asymmetry Identified on Mammography: Correlation with Imaging Outcome and Pathologic Findings. American Journal of Roentgenology. 2007;188(3):667-675.
Woods RW, Sisney GS, Salkowski LR, Shinki K, Lin Y, Burnside ES. The mammographic density of a mass is a significant predictor of breast cancer. Radiology. 2011;258(2):417-425
Park JW, Ko KH, Kim EK, Kuzmiak CM, Jung HK. Non-mass breast lesions on ultrasound: final outcomes and predictors of malignancy. Acta Radiol. 2017;58(9):1054-1060.
Lee J, Lee JH, Baik S, et al. Non-mass lesions on screening breast ultrasound. Med Ultrason. 2016;18(4):446-451
Uematsu T. Non-mass lesions on breast ultrasound: why does not the ACR BI-RADS breast ultrasound lexicon add the terminology? J Med Ultrason (2001). 2023;50(3):341-346.
Avdan Aslan A, Gültekin S, Esendağli Yilmaz G, Kurukahvecioğlu O. Is There Any Association Between Mammographic Features of Microcalcifications and Breast Cancer Subtypes in Ductal Carcinoma In Situ? Academic Radiology. 2021;28(7):963-968.
Berg WA, Zhang Z, Lehrer D, et al. Detection of Breast Cancer with Addition of Annual Screening Ultrasound or a Single Screening MRI to Mammography in Women with Elevated Breast Cancer Risk. JAMA. 2012;307(13):1394-1404
Buchberger W, Geiger-Gritsch S, Knapp R, Gautsch K, Oberaigner W. Combined screening with mammography and ultrasound in a population-based screening program. Eur J Radiol. 2018;101:24-29.
Lee JM, Arao RF, Sprague BL, et al. Performance of Screening Ultrasonography as an Adjunct to Screening Mammography in Women Across the Spectrum of Breast Cancer Risk. JAMA Intern Med. 2019;179(5):658-667
Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology. 1995;196(1):123-134.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
International Journal of Public Health Asia Pacific (IJPHAP) is licensed under a Creative Commons Attribution-Non-Commercial-No Derivatives 4.0 international (CC BY-NC-ND 4.0) license, unless otherwise stated. Please read our Policies page for more information on Open Access, copyright, and permissions.
