Preoperative mammographic features predict clinicopathological risk factors for the development of local recurrence in breast cancer

This study attempts to correlate preoperative mammographic features with es tablished clinicopathological risk factors for local recurrence with a view to selecting patients who might be unsuitable for breast-conserving surger y. A total of 357 patients underwent surgery for invasive breast cancer. Al l patients' preoperative mammograms were reviewed by a single radiologist ( LW) blinded to clinicopathological features. The independent sample t-test and chi-squared tests were used to correlate preoperative mammographic feat ures with established clinicopathological risk factors for the development of local recurrence. The presence of extensive in situ disease within the t umour was associated with both casting calcification and absence of a mammo graphic nidus (P=0.0001 and 0.002 respectively) but not with mammographic d ensity. Furthermore casting calcification (P = 0.003), absence of a mammogr aphic nidus (P=0.027) and maximum nidus size (P = 0.014) were all predictor s of tumour bed positivity. This study has demonstrated that preoperative m ammograms can be used to identify those patients at risk of occult disease and help select those patients that may be unsuitable for breast-conserving surgery. (C) 2000 Harcourt Publishers Ltd.