Mammographic finding as predictor of survival in 1-9 mm invasive breast cancers. Worse prognosis for cases presenting as calcifications alone

Purpose. To investigate breast cancer survival in small invasive breast cancers in relation to mammographic findings. Materials and methods. We investigated a consecutive series of 96 cases of 1-9 mm small invasive breast cancers diagnosed 1988-1994. Median follow-up of the survivors was 7 years (range: 4.5-10.5). Mammographic findings were classified into rounded masses, spiculated masses, calcifications (casting or pleomorphic) and masses combined with calcifications. Lymph node status and histological malignancy grade were also evaluated. Eight year survival rate in breast cancer was estimated with the Kaplan-Meier method and risk of death with proportional-hazards regression. Results. 6/96 women died from breast cancer. 3/14 had calcifications alone, 2/56 with spiculated masses, 1/12 with rounded masses. 5/78 who died were node-negative cancers and 1/4 was node-positive. The survival rate for the whole group was 93 %: 77 % for the calcifications alone group, 95 % for spiculated masses and 91 % for rounded masses. The survival rate for the node-negative cancers was 92 % compared to 75 % for node-positive cancers. Calcifications alone (p = 0.01) and node positivity (p = (0) over dot .03) had each independent significant higher risk of death taking finding, node status and grade into account. Conclusion. Small invasive breast cancers mammographically presenting as casting or pleomorphic calcifications alone have a significantly worse prognosis than other types.