Mammographic Microcalcifications and Breast Cancer: A Case - Control Study

Microcalcifications are among the earliest radiographic findings suggestive of breast malignancy and are often detected in women undergoing diagnostic mammography. Their association with breast cancer, independent of other risk factors, is clinically important but not fully understood.

To investigate the associations between mammographic microcalcifications and breast cancer risk in women undergoing diagnostic mammography.

Case‒control study.

Breast Care Unit (BCU), Rehman Medical Institute (RMI), Peshawar, Pakistan.

Three hundred women aged 30 years and above who underwent diagnostic mammography; 150 patients with histologically confirmed breast cancer and 150 (age, menopausal status and ACR density) matched controls with normal breasts.

The presence of microcalcifications on mammography. Covariates: ACR breast density, menopausal status, and age group. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated via multivariable logistic regression.

Microcalcifications were significantly more common in patients (50.7%) than in controls (20.7%) and were independently associated with breast cancer (adjusted OR 5.51, 95% CI: 3.02-10.05; p<0.001). Compared with premenopausal women, perimenopausal women had the highest odds of having breast cancer (adjusted OR 14.30, 95% CI: 3.80-53.78, p<0.001), followed by postmenopausal women (adjusted OR 4.50, 95% CI: 1.74-11.63, p=0.002). The ACR breast density categories B and C were significantly associated with microcalcifications but not independently with breast cancer.

Mammographic microcalcifications are strong independent predictors of breast cancer, particularly among peri- and postmenopausal women, highlighting their clinical value in risk stratification and diagnostic evaluation.