Breast microcalcifications: Multivariate analysis of radiologic and clinical factors for carcinoma
Breast microcalcifications: Multivariate analysis of radiologic and clinical factors for carcinoma
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DOI：
10.1007/s00268-001-0220-3
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发表时间：
2002-03-01
影响因子：
2.6
通讯作者：
Dauver, N
中科院分区：
文献类型：
--
作者：
Fondrinier, E;Lorimier, G;Dauver, N
筛查性乳房X线摄影有助于通过早期发现和治疗不可触及的病变来提高乳腺癌的生存率。微钙化在这个过程中至关重要。在活检中发现微钙化的恶性病变的百分比从10%到40%不等。本研究的目的是评估临床和放射学记录与恶性乳腺疾病之间的关系。为了建立研究的基础，前瞻性地回顾了204名妇女的211个乳腺摄影文件，这些文件显示了聚集的微钙化，并回顾性地绘制了临床记录。所有病例均进行了连续性病理分析。通过单变量和多变量分析研究每个标准的癌症价值。第一次分析是在整个人群中进行的，第二次分析是在形态学亚组中进行分层。恶性病变99例（47%）。在整个组中，没有临床标准是显著的。在单变量分析中，5个放射学变量具有显著性：形态类型（p < 0.0001）、每簇钙化数量（p < 0.0001）、线性或三角形分布（p < 0.0002）、区域直径（p < 0.01）和簇数量（p = 0.011）。在多变量分析中，两个标准仍然是显著的：形态学类型4（不规则点状）或5（蠕虫状）微钙化（Le Gal分类）（p < 0.0001）和直径大于25的簇非（p = 0.032）。在亚组中，在多变量分析中，规则点状微钙化组（2型）的“年龄> 60岁”标准具有统计学意义;对于不规则点状微钙化（4型），“微钙化数量> 20”具有统计学意义。微钙化的形态学特征必须是评价的第一标准。它们允许识别特征性良性（环形钙化）或恶性钙化（蠕虫状钙化）。对于其余的钙化类型，必须考虑其他标准，它们的值随形态学方面而变化。这些发现对患有微钙化的女性的管理具有意义，可以帮助乳腺专家做出治疗决定。
Screening mammography contributes to the improvement of breast carcinoma survival through early detection and treatment of non-palpable lesions. Microcalcifications are of fundamental importance in this process. The percentage of malignant lesions found in biopsies for microcalcifications varies from 10% to 40%. The purpose of this study was to evaluate the relationship between clinical and radiologic records and the presence of malignant breast diseases. To establish the basis for the study, 211 mammographic files showing clustered microcalcifications from 204 women were prospectively reviewed and clinical records were retrospectively drawn. Definitive pathologic analysis was available for all. The value for cancer of each criterion was investigated by univariate and multivariate analyses. A first analysis was performed on the entire population and a second one was performed with stratification on morphologic subgroups. There were 99 malignant lesions (47%). In the entire group, no clinical criterion was significant. In the univariate analysis, five radiologic variables were significant: morphologic type (p < 0.0001), number of calcifications per cluster (p < 0.0001), linear or triangular distribution (p < 0.0002), diameter of the area (p < 0.01), and number of clusters (p = 0.011). In the multivariate analysis, two criteria remained significant: morphologic type 4 (irregularly punctiform) or 5 (vermicular) microcalcifications (Le Gal's classification) (p < 0.0001) and diameter of the cluster larger than 25 non (p = 0.032). In subgroups, in the multivariate analysis, the "age > 60 years" criterion was statistically significant in the group of regular punctiform microcalcifications (type 2); for irregularly punctiform microcalcifications (type 4), "number of microcalcifications > 20" was significant. The morphologic features of microcalcifications must be the first criterion evaluated. They permit identification of characteristically benign (annular calcifications) or malignant calcifications (vermicular calcifications). For the remainder of the calcification types, other criteria must be taken into account, and their value vary with (according to) the morphologic aspect. These findings have implications for the management of women with microcalcifications and could help breast specialists make treatment decisions.