Imaging Biomarkers for HER2-Positive Breast Cancer: Evidence from an Observational Study

Background: Mammographic microcalcifications (MCs) are a common early radiological finding in breast cancer, but their significance in relation to molecular subtypes, particularly HER2-positive tumors, remains under investigation. Objectives: To evaluate the association between MCs and HER2 status in invasive breast cancer. Methods: A retrospective study was conducted on 185 patients treated at a breast unit between 2018 and 2023. Clinical, histological, and molecular data were analyzed. Logistic regression was used to identify independent predictors of MCs. Results: MCs were present in 27% of HER2-positive patients and 16.15% of HER2-negative patients (p < 0.001). HER2 positivity was the only significant independent predictor (OR = 5.89; 95% CI: 2.42-14.30; p < 0.001). Age, breast density, and histology were not associated. Conclusions: MCs are significantly associated with HER2 positivity and may serve as an early imaging marker of aggressive disease, supporting the integration of radiologic and molecular diagnostics.