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《Chinese Journal of Radiology》 2003-04
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Mammographic features at predicting the presence of an extensive intraductal component in early stage breast carcinoma: mammographic-pathologic correlation

GU Ya jia *, ZHOU Kang rong, ZHANG Ting qiu, WANG Jiu hua, CHEN Tong zhen *Department of Radiology, the Affiliated Cancer Hospital of Fudan University, Shanghai 200032, China  
Objective To evaluate the value of mammographic findings at predicting the presence of an extensive intraductal component (EIC), a major factor in determining breast conserving surgery Methods A prospective study of 348 consecutive mammograms in patients with stage Ⅰ or Ⅱ breast carcinoma, including infiltrating ductal carcinoma ( n =297), ductal carcinoma in situ (DCIS) associated with small invasive foci ( n =8), mucinous carcinoma ( n =21), and medullary carcinoma ( n =22), was performed to determine the predictive value of mammographic features in evaluating the presence or absence of an EIC Results (1) EIC+ cancers were significantly more likely to show the lesion with microcalcifications in comparing with EIC- cases (66 4% vs 20 4%, χ 2=75 29, P 0 001) In particular, the presence of microcalcifications alone was more common for EIC+ cancers than for EIC- cancers (21 1% vs 2 0%, χ 2=52 56, P 0 001) (2) 54 6% of patients in whom mammograms showed only a mass and 19 4% of patient with a palpable mass clinically but normal mammograms were seen in EIC- cases, compared with 25 0% and 5 9% respectively of EIC+ cases(both P 0 001) (3) Distortion with or without microcalcifications had no significant difference in predicting the presence or absence of an EIC ( P 0 05) (4) Positive predictive value calculations showed that the presence of microcalcifications alone and the extent of microcalcification distribution greater than 3 cm conveyed a 88 9% and 95 8% likelihood that a cancer will be EIC+, respectively, and a mass with microcalcifications was 67 8% On the contrary, the positive predictive value of the number of microclcification less than 10 or normal mammograms but a palpable mass clinically for an EIC- cancer was 96 6% and 80 9%, respectively, and a mammographic mass was 73 8% Conclusion The mammographic findings may be useful preoperatively for the differentiation between patients with and without an EIC To some extent, the breast conserving therapy could be determined on the basis of these mammographic findings The lesions with microcalcifications, particularly ≥3 cm in its distribution areas, were much more commonly associated with EIC+ cancers than with EIC- cancers
【CateGory Index】: R737.9
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