Correlations between the mammographic features of screen detected invasive breast cancer and pathological prognostic factors

The success of any mammographic breast screening programme depends on the detection of carcinomas with overall good prognostic features. Knowledge of mammographic correlates of prognostic features would therefore be of interest. The screening mammograms of 212 patients with prevalent round screen detected invasive cancer were assessed by two radiologists without knowledge of tumour pathological prognostic indicators. The mammographic findings were then correlated with the following prognostic indicators: tumour grade, lymph node stage, and vascular invasion status. The following radiological appearances showed significant correlation with histological grade: spiculate mass with low histological grade (P = 0.006), and ill-defined mass (P = 0.02), calcification suggestive of comedo DCIS (P = 0.001) and all calcification (P = 0.03) with high histological grade. No correlations were found between lymph node stage and mammographic features. A significant correlation was found between asymmetric density and the presence of vascular invasion (P= 0.026). Tumours presenting as poorly defined masses and asymmetric densities tend to be large and tumours presenting as architectural distortion small at mammographic detection. Significant correlations exist between tumour grade and mammographic appearances of screen detected breast cancer. No correlations exist between mammographic appearance and lymph node stage.