The role of mammographic findings associated with breast microcalcifications in the choice of imaging tactics

ackground. Calcifications are considered the most common mammography findings, detected in 80% of cases. Although the majority of calcifications are not dangerous and represent benign changes that do not require further examination and follow-up, in one third of cases, suspicious microcalcifications (MC) are verified as malignant. In addition, MC can be identified with associated findings such as architectural distortions, asymmetries, and masses, which can further complicate imaging interpretation.Objective of the study: to evaluate the impact of concomitant findings associated with MC on the risk of breast cancer detection.Materials and methods. An analysis of radiological and pathomorphological studies was carried out in 129 women with suspicious MC, aged from 31 to 85 years, with an average age of 49.0 years. Sampling was performed under ultrasound and X-ray guidance, depending on the ability to visualize the suspicious area with MC.Results. MC with associated findings (19.38%) increase the risk of detecting malignant pathology at the verification stages in comparison with suspicious MC without associated findings (8.53%). The probability of detecting an invasive component increases, which is further confirmed by the increased frequency of visualization of these associated findings on ultrasound (18.6%) compared to the women without associated findings (6.2%), and the frequency of breast complaints in female patients. The most frequent and dangerous concomitant findings were masses (39.28%) and architectural distortions (42.85%). The probability of detecting concomitant findings associated with MC increased when visualizing suspicious MC in the upper-outer quadrant, when the size of the MC area was more than 15 mm and in the age group of elderly and geriatric patients (p < 0.05).Conclusions. Whenever possible, physicians should immediately verify suspicious areas associated with MC. Particular attention should be paid to masses and architectural distortions associated with MC. Risks of associated findings may include the size of the MC area > 15 mm, localization in the upper-outer quadrant of the breast, and the elderly and geriatric patients.