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Br J Radiol. 2018 Jun 21:20170942. doi: 10.1259/bjr.20170942. [Epub ahead of print]

Microcalcification-associated breast cancer: HER2-enriched molecular subtype is associated with mammographic features.

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The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology , Luoyang , China.



To investigate whether the mammographic features were different between breast cancer HER2-enriched molecular subtype and non-HER2-enriched molecular subtype.


283 microcalcification-associated breast cancers were identified (HER2-enriched: n = 57; non-HER2-enriched: n = 226). Mammographic tumor mass and calcification features in relation to HER2 molecular subtype were analyzed.


On univariate analysis, HER2-enriched molecular subtype rates were significantly higher (a) in tumor size <= 2 cm 33 of 57 [57.9%]) than in tumor size >2 cm lesions (22 of 226 [9.7%]) (p = 0.007), (b) in non-spiculated mass 39 of 57 [68.4%]) than in spiculated mass lesions (18 of 226 [7.9%]) (p = 0.034),(c) in calcifications extent >2 cm (41of 57 [71.9%]) lesions than in calcifications extent <= 2 cm lesions (16 of 226 [7.1%]) (p < 0.001)and (d) in calcification density >20/cm2 (44 of 57 [71.2%]) lesions than in calcification density <= 20/cm2 lesions (13 of 226 [5.8%]) (p = 0.034).On multivariate analysis, three mammographic features (tumor size >2 cm vs size⩽2 cm OR: 0.415 95% CI: 0.215 to 0.802, p = 0.009, spiculated mass vs non-spiculated mass OR: 0.226 95% CI: 0.114 to 0.446, p < 0.001 and calcifications extent >2 cm vs calcifications extent <= 2 cm OR: 7.754, 95% CI: 3.100 to 19.339P < 0.001) were independent predictors. Our results indicated that small tumor size, non-spiculated mass and calcification extent >2 cm are more likely to be HER2 molecular subtype. The discrimination of this model, as quantified by the AUC, was 0.751 (95%CI: 0.701 to 0.854).


Our study presents a prediction model that incorporates the mammographic features of tumor size, non-spiculated mass and calcification extent, which can potentially be used to preoperative predict breast cancer HER2-enriched subtype. Advancesinknowledge: Mammographic features can noninvasively visualize breast tumor phenotype characteristics.


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