Ipsilateral microcalcifications after breast-conserving surgery: is it possible to differentiate benign from...

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Microcalcifications after breast-conserving surgery (BCS) can indicate recurrence.
• Stereotactic biopsy is used to evaluate these findings.

Purpose of the Study:

• To analyze stereotactic biopsies of microcalcifications in patients with prior ipsilateral BCS.
• To determine the positivity rate and associations with primary cancer or mammographic appearance.
• To assess the risk of recurrence based on calcification characteristics.

Main Methods:

• Retrospective review of patients from 2018-2020.
• Data collected from radiological databases, electronic patient records, and national imaging systems.
• Analysis of clinicopathological features and calcification characteristics.

Main Results:

• 31% of recurrences post-BCS presented as isolated microcalcifications.
• 53% of stereotactic biopsies of ipsilateral calcifications showed recurrence.
• Positive margin status, fine pleomorphic, and fine linear calcifications were associated with malignancy.
• Coarse calcifications were benign; calcifications within the tumor bed were more likely benign.

Conclusions:

• Stereotactic biopsy positivity rate for microcalcifications post-BCS is significant.
• Specific calcification types (fine pleomorphic, fine linear) and locations (remote from tumor bed) increase malignancy risk.
• Coarse calcifications or those within the tumor bed may be managed with surveillance, avoiding biopsy.