Suspicious amorphous microcalcifications detected on full-field digital mammography: correlation with histopathology

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFERREIRA, Vera Christina Camargo de Siqueira
dc.contributor.authorETCHEBEHERE, Elba Cristina Sá de Camargo
dc.contributor.authorBEVILACQUA, José Luiz Barbosa
dc.contributor.authorBARROS, Nestor de
dc.date.accessioned2018-06-07T14:15:20Z
dc.date.available2018-06-07T14:15:20Z
dc.date.issued2018
dc.description.abstractAbstract Objective: To evaluate suspicious amorphous calcifications diagnosed on full-field digital mammography (FFDM) and establish correlations with histopathology findings. Materials and Methods: This was a retrospective study of 78 suspicious amorphous calcifications (all classified as BI-RADS® 4) detected on FFDM. Vacuum-assisted breast biopsy (VABB) was performed. The histopathological classification of VABB core samples was as follows: pB2 (benign); pB3 (uncertain malignant potential); pB4 (suspicion of malignancy); and pB5 (malignant). Treatment was recommended for pB5 lesions. To rule out malignancy, surgical excision was recommended for pB3 and pB4 lesions. Patients not submitted to surgery were followed for at least 6 months. Results: Among the 78 amorphous calcifications evaluated, the histopathological analysis indicated that 8 (10.3%) were malignant/suspicious (6 classified as pB5 and 2 classified as pB4) and 36 (46.2%) were benign (classified as pB2). The remaining 34 lesions (43.6%) were classified as pB3: 33.3% were precursor lesions (atypical ductal hyperplasia, lobular neoplasia, or flat epithelial atypia) and 10.3% were high-risk lesions. For the pB3 lesions, the underestimation rate was zero. Conclusion: The diagnosis of precursor lesions (excluding atypical ductal hyperplasia, which can be pB4 depending on the severity and extent of the lesion) should not necessarily be considered indicative of underestimation of malignancy. Suspicious amorphous calcifications correlated more often with precursor lesions than with malignant lesions, at a ratio of 3:1.
dc.description.abstractResumo Objetivo: Correlacionar o achado mamográfico de calcificações amorfas suspeitas diagnosticadas na mamografia digital com seus diagnósticos anatomopatológicos. Materiais e Métodos: Setenta e oito casos de calcificações amorfas suspeitas (todas classificadas como BI-RADS® 4) detectadas na mamografia digital e submetidas a biópsia percutânea assistida à vácuo foram retrospectivamente avaliados. A classificação anatomopatológica utilizada na biópsia foi: pB2 para lesão benigna, pB3 para lesão com potencial incerto de malignidade, pB4 para lesão suspeita, e pB5 para lesão considerada maligna. O tratamento foi recomendado para as lesões pB5, a exérese cirúrgica foi indicada para lesões pB3 e pB4, para descartar malignidade, e o seguimento evolutivo foi adotado para as demais pacientes. Resultados: A histologia demonstrou 8 (10,3%) casos malignos (6 lesões pB5 e 2 lesões pB4) e 36 (46,2%) casos benignos (pB2). As demais 34 (43,6%) lesões foram classificadas como pB3 (33,3% foram lesões precursoras - hiperplasia ductal atípica, neoplasia lobular ou atipia epitelial plana - e 10,3% foram lesões de alto risco). A taxa de subestimação das lesões pB3 foi zero. Conclusão: O diagnóstico de lesões precursoras (excluindo hiperplasia ductal atípica, que pode corresponder a lesão pB4 dependendo da severidade e extensão dos achados) na biópsia percutânea assistida à vácuo por calcificações amorfas suspeitas não necessariamente representa lesão subestimada. Calcificações amorfas suspeitas se associaram a lesões precursoras numa proporção de 3:1 em relação às lesões malignas.
dc.description.indexPubMed
dc.identifier.citationRADIOLOGIA BRASILEIRA, v.51, n.2, p.87-94, 2018
dc.identifier.doi10.1590/0100-3984.2017.0025
dc.identifier.issn1678-7099
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/26767
dc.language.isoeng
dc.publisherColégio Brasileiro de Radiologia e Diagnóstico por Imagem
dc.relation.ispartofRadiologia Brasileira
dc.rightsopenAccess
dc.rights.holderCopyright Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
dc.subjectBreast stereotaxis biopsy
dc.subjectCalcification
dc.subjectDiagnosis
dc.subjectAmorphous morphology
dc.subjectDigital mammography
dc.subjectBreast cancer
dc.subjectNeoplasias mamárias/diagnóstico
dc.subjectMamografia digital
dc.subjectBiópsia por agulha
dc.subjectMicrocalcificações mamárias
dc.subjectCalcificações amorfas
dc.subjectCâncer de mama
dc.subject.wosRadiology, Nuclear Medicine & Medical Imaging
dc.titleSuspicious amorphous microcalcifications detected on full-field digital mammography: correlation with histopathology
dc.title.alternativeMicrocalcificações amorfas suspeitas detectadas na mamografia digital: correlação histológica
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalETCHEBEHERE, Elba Cristina Sá de Camargo:Universidade Estadual de Campinas, Brazil
hcfmusp.author.externalBEVILACQUA, José Luiz Barbosa:Hospital Sírio-Libanês, Brazil
hcfmusp.citation.scopus8
hcfmusp.contributor.author-fmusphcVERA CHRISTINA CAMARGO DE SIQUEIRA FERREIRA
hcfmusp.contributor.author-fmusphcNESTOR DE BARROS
hcfmusp.description.beginpage87
hcfmusp.description.endpage94
hcfmusp.description.issue2
hcfmusp.description.volume51
hcfmusp.origemsciELO
hcfmusp.origem.pubmed29743735
hcfmusp.origem.scieloSCIELO:S0100-39842018000200087
hcfmusp.origem.scopus2-s2.0-85047805738
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