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 can cers 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 o f 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 spi culated masses and 91 % for rounded masses. The survival rate for the node- negative cancers was 92 % compared to 75 % for node-positive cancers. Calci fications alone (p = 0.01) and node positivity (p = (0) over dot .03) had e ach independent significant higher risk of death taking finding, node statu s and grade into account. Conclusion. Small invasive breast cancers mammographically presenting as ca sting or pleomorphic calcifications alone have a significantly worse progno sis than other types.