Management of microcalcifications that develop at the lumpectomy site after breast-conserving therapy.

Abstract

PURPOSE:

To design a decision tree according to time from irradiation and site, morphology, and number of microcalcifications for the rational treatment of patients with microcalcifications at the lumpectomy site after breast-conserving therapy (BCT), to minimize performance of biopsy.

MATERIALS AND METHODS:

From a database of 504 women selected to receive BCT, those developing probably benign microcalcifications within 3 years of BCT received close follow-up with mammography. Patients developing fewer than four probably benign microcalcifications more than 3 years after treatment were offered mammography or biopsy. If microcalcifications appeared malignant or patients developed four or more microcalcifications after 3 years, biopsy was performed.

RESULTS:

Twenty-eight patients (29 breasts [5.7%]) developed microcalcifications confined to the lumpectomy site. Fifteen patients (15 breasts) developed microcalcifications within 3 years of BCT and were followed up with mammography. Thirteen patients (14 breasts) developed microcalcifications confined to the lumpectomy site after more than 3 years. Among the latter group, microcalcifications appeared malignant in four breasts, and biopsy specimens revealed three recurrences. The remaining 10 breasts were followed up with mammography. No patient undergoing mammographic follow-up without biopsy has had clinical evidence of local failure throughout the follow-up period.

CONCLUSION:

Follow-up mammography is an option when benign-appearing microcalcifications develop at the lumpectomy site depending on time of appearance and number; it is the primary recommendation when these microcalcifications develop within 3 years after treatment.

• Authors: S A Vora, D E Wazer, M J Homer
• Journal: Radiology (Radiology) Vol. 203 Issue 3 Pg. 667-71 (Jun 1997) ISSN: 0033-8419 [Print] United States
• PMID: 9169686 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Algorithms
• Biopsy
• Breast (pathology, radiation effects)
• Breast Diseases (diagnostic imaging, pathology, therapy)
• Breast Neoplasms (diagnostic imaging, pathology, radiotherapy, surgery)
• Calcinosis (diagnostic imaging, pathology, therapy)
• Carcinoma (diagnostic imaging, pathology, radiotherapy, surgery)
• Carcinoma in Situ (diagnostic imaging, pathology, radiotherapy, surgery)
• Carcinoma, Ductal, Breast (diagnostic imaging, pathology, radiotherapy, surgery)
• Carcinoma, Lobular (diagnostic imaging, pathology, radiotherapy, surgery)
• Combined Modality Therapy
• Decision Trees
• Female
• Follow-Up Studies
• Humans
• Information Systems
• Mammography
• Mastectomy, Segmental
• Middle Aged
• Neoplasm Recurrence, Local (diagnostic imaging, pathology)
• Prospective Studies
• Radiotherapy, High-Energy