Mammographic microcalcifications and risk of breast cancer

• Published in: British journal of cancer 2021-08, Vol.125 (5), p.759-765
• Main Authors: Azam, Shadi, Eriksson, Mikael, Sjölander, Arvid, Gabrielson, Marike, Hellgren, Roxanna, Czene, Kamila, Hall, Per
• Format: Article
• Language: English
• Subjects: 631/67/1347; 631/67/2324; Adult; Aged; Aged, 80 and over; Biomedical and Life Sciences; Biomedicine; Breast cancer; Breast Density; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - genetics; Calcinosis - complications; Calcinosis - diagnostic imaging; Cancer Research; Drug Resistance; Epidemiology; Female; Humans; Logistic Models; Mammography; Mammography - methods; Middle Aged; Molecular Medicine; Oncology; Post-menopause; Postmenopause; Premenopause; Prospective Studies; Radiographic Image Interpretation, Computer-Assisted - methods; Risk factors; Sweden
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/s41416-021-01459-x

Background Mammographic microcalcifications are considered early signs of breast cancer (BC). We examined the association between microcalcification clusters and the risk of overall and subtype-specific BC. Furthermore, we studied how mammographic density (MD) influences the association between microcalcification clusters and BC risk. Methods We used a prospective cohort ( n  = 53,273) of Swedish women with comprehensive information on BC risk factors and mammograms. The total number of microcalcification clusters and MD were measured using a computer-aided detection system and the STRATUS method, respectively. Cox regressions and logistic regressions were used to analyse the data. Results Overall, 676 women were diagnosed with BC. Women with ≥3 microcalcification clusters had a hazard ratio [HR] of 2.17 (95% confidence interval [CI] = 1.57–3.01) compared to women with no clusters. The estimated risk was more pronounced in premenopausal women (HR = 2.93; 95% CI = 1.67–5.16). For postmenopausal women, microcalcification clusters and MD had a similar influence on BC risk. No interaction was observed between microcalcification clusters and MD. Microcalcification clusters were significantly associated with in situ breast cancer (odds ratio: 2.03; 95% CI = 1.13–3.63). Conclusions Microcalcification clusters are an independent risk factor for BC, with a higher estimated risk in premenopausal women. In postmenopausal women, microcalcification clusters have a similar association with BC as baseline MD.