Table 1 Characteristics of studies reporting on mammographic morphology of calcifications associated with clinicopathological factors
Study characteristics | Patients | Assessment clinicopathological factors | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
Molecular subtype | ||||||||||
Ref., country, recruitment period | (Observational) study design | Setting of recruitment | Single- or multi-center | Follow-up (years) | No. of DCIS patients with calcifications used in analysis | No. of lesions presenting as calcifications only | Mean age in years (range/SD) of study population | Mean histologic size of DCIS in cm (range/SD) | Assay receptor expression | Cut-off |
Avdan Aslan et al. 2021 [16], Turkey, 2007–2013 | Cohort | University hospital | Single | N/A | 66 | NS | 53 (24–73)a | NS (0.4–13.4) | IHC NOS | ER/PR: ≥ 10% nuclear staining Her2: IHC 3+ |
Bae et al. 2013 [17], South Korea, 2006–2011 | Cohort | University hospital | Single | N/A | 101 | 101 | 36 (27–83) | 3.7 (0.5–12.3)a | IHC NOS; FISH PathVysion | ER/PR: ≥ 10% nuclear staining Her2: IHC 3+ or (IHC 2+ and FISH+) |
Bagnall et al. 2001 [18], England, 1994–1999 | Cohort | City hospital | Single | N/A | DCIS: 78 DCIS + IBC: 38 | 116 | 58 (40–80) | NS | N/A | N/A |
Barreau et al. 2005 [19], France, 1980–1999 | Cohort | Regional cancer center | Single | N/A | 686 | NS | 52.4 (19–88) | NS | N/A | N/A |
de Roos et al. 2006 [21], The Netherlands, 1991–2003 | Cohort | Hospital | Single | N/A | 77 | NS | 58.8 (NS)a | 2.6a | N/A | N/A |
de Roos et al. 2004 [20], the Netherlands, 1986–2000 | Cohort | Hospital | Single | N/A | 87 | 70 | 59 (NS) | 3.6 (NS) | N/A | N/A |
Dinkel et al. 2000 [22], Germany, 1993–1998 | Cohort | University hospital | Single | N/A | 47 | NS | 53.4 (26.5–77.3) | 1.28 (0.4–4) | N/A | N/A |
Evans et al. 2010 [23], UK, NS | Cohort | Nationwide cohort | Multi | N/A | 1783 | NS | NS (50–69) | NS (NS) | N/A | N/A |
Hofvind et al. 2011 [24], Norway, 1995–2007 | Cohort | Nationwide cohort | Multi | N/A | 202 | NS | 58.3 (49.3–71.2) | NS (NS) | N/A | N/A |
Holmberg et al. 2013 [25], Sweden, 1987–1999 | Case-cohort study within a randomized trial | Nationwide cohort | Multi | 8 | 162 | NS | Subcohort: 56.7 Cases outside: 55.4 | NS (NS) | N/A | N/A |
Kessar et al. 2002 [26], England, 1989–1996 | Cohort | Hospital | Single | N/A | 102 | 58 | 58 (25–89) | NS (NS) | N/A | N/A |
Kim et al. 2015 [27], South Korea, 2007–2013 | Cohort | University hospital | Single | N/A | 77 | 66 | 53.8 (26–74) | Non-calcified: 2.2 (2.1) Calcified 2.8 (2.2) | IHC NOS; SISH NOS | ER/PR: Allred score ≥ 3 Her2: IHC 3+ or (IHC 2+ and SISH+) |
Kong et al. 2020 [28], China, January 2018–December 2018 | Cohort | University hospital | Single | N/A | 79 | NS | 48 (40–57) | NS | N/A | N/A |
Lee et al. 2000 [29], US, 1992–1999 | Cohort | Yale University School of Medicine | Single | N/A | DCIS: 42 DCIS + IBC: 17 | NS | 59 (36–86) | NS | N/A | N/A |
Lee et al. 2021 [30], South Korea, 2009–2019 | Cohort | University hospital | Single | N/A | 83 | NS | 52.3 (31–83) | NS (NS) | IHC NS; dual ISH (Ventana medical systems) | NS |
Lilleborge et al. 2021 [31], Norway, 1995–2016 | Case-control | BreastScreen Norway | Multi | Mean 5.2 | DCIS: 131 DCIS + IBC: 80 | 211 | Cases: 59.8 (55.2–65.7) controls: 59.4 (54.1–63.7) | Cases: 2 (1.3–3.8) Controls: 2 (0.9–3.5) | N/A | N/A |
Nishimura et al. 2004 [33], Japan, 1995–2001 | Cohort | Cancer institute | Single | N/A | DCIS: 124 IBC: 33 | NS | NS (NS) | NS | N/A | N/A |
Rauch et al. 2016 [34], US, 1996–2009 | Cohort | University hospital | Single | Mean 7 (range 1–16) | 1438a | NS | 55 (11) | 2.25 (2.5) | N/A | N/A |
Rominger et al. 2015 [35], US, 2002–2003 | Cohort | Academic tertiary-care institution | Single | Mean 6.8 | DCIS: 57 IBC: 42 | NS | NS (NS) | NS | IHC NOS | NS |
Stomper et al. 2003 [37], US, 1991–2001 | Cohort | Mammography center and a multidisciplinary breast clinic in a cancer institute | Multi | N/A | DCIS: 198 DCIS + IBC: 96 IBC: 10 | 304 | Median: 54 (29–86) | NS | N/A | N/A |
Szynglarewicz et al. 2016 [38], Poland, 2009–2014 | Cohort | University hospital | Single | N/A | 127 | 127 | 59.6 (50–69) | NS (NS) | N/A | N/A |
Tabar et al. 2011 [40], Sweden, 1977–2007 | Cohort | University hospitals | Multi | Falun: mean 5, Roanoke: mean 3 | DCIS: 498 IBC: 353 | NS | NS (NS) | NS (0.1–1.4) | N/A | N/A |
Tan et al. 2000 [41], Singapore, 1993–1996 | Cohort | Singapore breast screening project | Multi | N/A | 32 | 25 | Median: 57 (51–66) | NS | N/A | N/A |
Thurfjell et al. 2002 [43], Sweden, 1988–1994 | Cohort | University hospital | Single | N/A | DCIS: 57 IBC: 71 | DCIS: 50 IBC: 29 | Median: 61 (33–87) | NS | N/A | N/A |
Wang et al. 2019 [44], China, 2012–2015 | Cohort | University hospital | Single | N/A | 60 | 60 | DCIS: 48 (11) DCISM: 46 (8) | DCIS 2.1 (1.5) DCISM 3.4 (1.5) | N/A | N/A |
Woodard et al. 2019 [45], US, 2012–2017 | Cohort | University hospital | Single | N/A | 58 | 58 | 54.8 (9.7) | NS (NS) | N/A | N/A |
Zhang et al. 2021 [46], China, 2016–2020 | Cohort | University hospital | Single | N/A | 395 | 171 | Median: 50 (27–87) | DCIS: 67.8% < 2.7 DCIS-MI: 42.1% < 2.7 | N/A | N/A |
Zhou et al. 2017 [47], Sweden, 1986–2004 | Cohort | From Uppland and Västmanland counties | Multi | Mean 15.4 | 310 | NS | 57.5 (NS)a | NS (NS) | Tma data, IHC dako HercepTest; SISH NOS | ER/PR: > 10% HER2: SISH+ or IHC 3+ |
Zhou et al. 2014 [48], Sweden, 2005–2006 | Cohort | Academic hospital and central hospital | Multi | N/A | DCIS: 32 DCIS + IBC: 42 | NS | Majority (60.8%) > 55 yearsa | NS | N/A | N/A |
Study characteristics | Assessment clinicopathological factors | Assessment calcification morphology | |||||||
|---|---|---|---|---|---|---|---|---|---|
(molecular subtype) | Other | ||||||||
Ref., country, recruitment period | (Observational) study design | Assay grade | Number of readers | Assay | Imaging system (manufacturer) | Method of detection | No. of readers | Blinded | Calcification classification system |
Avdan Aslan et al. 2021 [16], Turkey, 2007–2013 | Cohort | Modified Bloom-Richardson Grading System | 1 (reviewed) | Comedonecrosis | Selenia (Hologic) | NS | 2 (reviewed) | Yes | BIRADS 5th edition (2013) |
Bae et al. 2013 [17], South Korea, 2006–2011 | Cohort | N/A | N/A | N/A | Senographe 2000D (GE Healthcare); Selenia (Hologic) | NS | 3 (reviewed) | Yes | BIRADS 4th edition (2003) |
Bagnall et al. 2001 [18], England, 1994–1999 | Cohort | N/A | N/A | Invasion | NS | SD and non-SD | NS | NS | NS (punctate, granular or linear) |
Barreau et al. 2005 [19], France, 1980–1999 | Cohort | WHO breast tumor classification 6th edition | NS | Comedocarcinoma, necrosis | NS | NS | 1 (reviewed) | NS | BIRADS (1993–2003) 1st - 4th edition |
de Roos et al. 2006 [21], The Netherlands, 1991–2003 | Cohort | N/A | Reclassified by 1 | Margin status | NS | SD and non-SD | 1 (reclassified) | Yes | Holland R, Hendriks JHCL (1994) |
de Roos et al. 2004 [20], the Netherlands, 1986–2000 | Cohort | EPWG and Van Nuys | 1 (reviewed) | N/A | NS | SD and non-SD | 1 (reviewed) | Partial, to histopathological subtype | Holland R, Hendriks JHCL (1994) |
Dinkel et al. 2000 [22], Germany, 1993–1998 | Cohort | Nuclear malignancy grade and EORTC grading | 1 (reviewed) | N/A | Mammomat 2 (Siemens) | NS |  ≥ 1 (reviewed) | Yes | Holland R, Hendriks JHCL (1994) |
Evans et al. 2010Â [23], UK, NS | Cohort | Cytonuclear grade | NS (pathology dataset) | Microscopic tumor size | NS | SD | NS | No | NS (Groups: casting/linear, granular/irregular, or punctate) |
Hofvind et al. 2011 [24], Norway, 1995–2007 | Cohort | Van Nuys | 1 (reviewed) | Distribution of calcifications | Rotolux/Planilux 400 (Siemens); Advanced Workstation 4.4 (GE Healthcare) | SD | 4 (reviewed) | yes, to side, site, size, clinical findings, and further histologies Information | Modified BIRADS 4th edition (2003) |
Holmberg et al. 2013 [25], Sweden, 1987–1999 | Case-cohort study within a randomized trial | Nuclear grade | NS | Local recurrence in the ipsilateral breast, age, necrosis, tumor size | NS | SD and non-SD | 1 (reviewed) | Yes | Tabar, L (2005) |
Kessar et al. 2002 [26], England, 1989–1996 | Cohort | Van Nuys | NS | N/A | NS | SD and non-SD | 3 (reviewed) | NS | NS (groups: pleomorphic, linear branching, punctate) |
Kim et al. 2015 [27], South Korea, 2007–2013 | Cohort | N/A | N/A | N/A | Selenia (Hologic) | SD | 2 (reviewed) | Yes | BIRADS 5th edition (2013) |
Kong et al. 2020 [28], China, January 2018–December 2018 | Cohort | NS | NS | N/A | Selenia (Hologic) | SD and non-SD | NS | NS | BIRADS 5th edition (2013) |
Lee et al. 2000 [29], US, 1992–1999 | Cohort | N/A | N/A | Invasion, defined as clear evidence of carcinoma in the stroma | NS | SD | 1 (reviewed) | Yes | BIRADS 1st edition (1993) |
Lee et al. 2021 [30], South Korea, 2009–2019 | Cohort | Van Nuys | NS | Comedonecrosis, ki67 | NS | NS | 2 | Yes | BIRADS 5th edition (2013) |
Lilleborge et al. 2021 [31], Norway, 1995–2016 | Case-control | N/A | N/A | Invasion, defined as breast cancer > 6 months after the diagnosis of DCIS | NS | SD | 1 (reviewed) | Yes | BIRADS 5th edition (2013) |
Nishimura et al. 2004 [33], Japan, 1995–2001 | Cohort | N/A | N/A | Invasion | NS | SD | NS | NS | BIRADS 3rd edition (1998) |
Rauch et al. 2016 [34], US, 1996–2009 | Cohort | NS | 1 of 11 (reviewed) | Presence of comedonecrosis, multicentricity and local recurrence | NS | NS | 2 (1 original reading and 1 rereading) | NS | BIRADS 5th edition (2013) |
Rominger et al. 2015 [35], US, 2002–2003 | Cohort | Van Nuys | NS | Local recurrence | NS | SD | NS | NS | BIRADS 5th edition (2013) |
Stomper et al. 2003 [37], US, 1991–2001 | Cohort | N/A | N/A | Invasion, extent of invasion and calcification size | High-resolution film-screen mammography including orthogonal magnification projections | SD | NS | Yes | Holland R, Hendriks JHCL (1994) |
Szynglarewicz et al. 2016 [38], Poland, 2009–2014 | Cohort | Nuclear grade based on College of American Pathologists | NS | Comedonecrosis, age (only p value), calcification distribution | NS | SD | 3 (1 reviewed) | Yes | Tabar, L (2005) |
Tabar et al. 2011 [40], Sweden, 1977–2007 | Cohort | N/A | N/A | Invasion | NS | SD and non-SD | 1 | Yes | Tabar, L (2004) |
Tan et al. 2000 [41], Singapore, 1993–1996 | Cohort | Nuclear pleomorphism based on Lagios | NS | Necrosis | NS | SD | NS | NS | Tabar, L (1997) |
Thurfjell et al. 2002 [43], Sweden, 1988–1994 | Cohort | Nuclear grade based on Elston and Ellis | 1 | Invasion | NS | SD and non-SD | 1 (reviewed) | NS | Tabar, L (1983) and BIRADS 3rd edition (1998) |
Wang et al. 2019 [44], China, 2012–2015 | Cohort | N/A | N/A | Micro invasion, defined as a microscopic focus of invasion ≤ 1 mm in the longest diameter within an area of DCIS | Planmed Nuance (Planmed) | NS | 2 (reviewed) | Yes | BIRADS 5th edition (2013) |
Woodard et al. 2019 [45], US, 2012–2017 | Cohort | N/A | N/A | Local recurrence (the Oncotype DX Breast DCIS assay) | NS | NS | 1 (reviewed) | Yes | BIRADS 5th edition (2013) |
Zhang et al. 2021 [46], China, 2016–2020 | Cohort | N/A | N/A | Microinvasion defined as the extension of cancer cells beyond the basement membrane into the adjacent tissues with no focus > 0.1 cm in the greatest dimension | Selenia (Hologic) | SD and non-SD | 2 | NS | BIRADS 5th edition (2013) |
Zhou et al. 2017 [47], Sweden, 1986–2004 | Cohort | EORTC | NS | Age, neoductgenesis, Tenascin-C, proliferation and recurrence | NS | SD and non-SD | 2 (reviewed) | Yes | Tabar, L (2004) |
Zhou et al. 2014 [48], Sweden, 2005–2006 | Cohort | N/A | N/A | Neoductgenesis | NS | NS | 2 | Yes | Tabar, L (2004) |