breast imaging findings of microcalcifications in ductal carcinoma in situ and their correlations with pathological and biological features

Background: mammography (mmg) is the primary screening tool for breast cancer, as microcalcifications are the most common mmg finding in ductal carcinoma in situ (dcis). the use of high-frequency transducers facilitates the visualization of calcifications on ultrasonography (usg), especially in patients with dense breasts and cancer symptoms. although a correlation has been reported between the imaging features of dcis and pathological features, few studies have focused on multiple imaging modalities. objectives: to evaluate the correlation of dcis microcalcifications in breast imaging with pathological and biological features. patients and methods: the mmg and usg findings of 125 lesions detected in 123 patients, diagnosed with pure dcis, were retrospectively reviewed according to the breast imaging-reporting and data system (bi-rads). the usg and comparable mmg findings of microcalcifications were divided into three groups: group 1 (mmg negative, usg negative), group 2 (mmg positive, usg negative), and group 3 (mmg positive, usg positive). the pathological findings (nuclear grade and comedo necrosis) and biological features [estrogen (er) positive group, human epidermal growth factor receptor 2 (her2) positive group, triple negative group, and ki-67 index] were compared with the mmg and usg features using chi-square test. results: microcalcifications were observed on mmg in 83 (66.4%) dcis lesions. positive microcalcifications on mmg were significantly associated with a high nuclear grade (p = 0.001) and comedo necrosis (p = 0.001). positive microcalcifications on mmg were significantly associated with er negativity (p = 0.023), her2 positivity (p = 0.002), and increased ki-67 index (p = 0.001). there were 62 lesions (49.6%) without microcalcifications on usg (group 1 and group 2), while there were 63 (50.4%) lesions with microcalcifications on usg (group 3). positive microcalcifications on mmg were significantly associated with er-negative group (p = 0.023), her2-positive group (p = 0.002), and increased ki 67 index (p = 0.001). conclusion: based on the present results, dcis microcalcifications detected via imaging were significantly associated with poor prognostic pathological factors, such as a high nuclear grade and comedo necrosis, as well as poor prognostic biological factors, including er negativity, her2 positive group, and a high ki-67 index.