Volume 14 Supplement 1

British Society of Breast Radiology Annual Scientific Meeting 2012

Open Access

Impact of full-field digital mammography on diagnostic work-up and surgical management of mammographic microcalcification

  • SM Bundred1,
  • J Zhou1,
  • S Whiteside1,
  • J Morris2 and
  • NJ Bundred2
Breast Cancer Research201214(Suppl 1):P20

DOI: 10.1186/bcr3275

Published: 9 November 2012


Full-field digital mammography (FFDM) increases detection of benign and malignant calcified breast lesions. Accurate nonoperative diagnosis of malignant impalpable breast lesions minimises numbers of therapeutic surgical procedures. Correct diagnosis of malignant mammographic microcalcification (MM) is important because upgraded lesions require repeat surgical procedures in 57% of cases (NHSBSP Audit 2012).


Screening and symptomatic women with MM (n = 1,479) were reviewed to determine the impact of FFDM (imaging with FFDM only since April 2010) on the positive predictive value (PPV), diagnostic accuracy and surgical management of MM. Demographic information, preoperative and postoperative diagnosis and number of surgical procedures were recorded for Group 1 (August 2007 to March 2010: n = 711) and Group 2 (April 2010 to May 2011: n = 768).


Reduction in PPV of biopsy for MM was observed (Group 1, 42.6%: Group 2, 32.7%; P < 0.0001). Correct or concordant nonoperative diagnosis increased with FFDM (Group 1, 89% vs. Group 2, 95%; P < 0.0001) and was achieved more often at first attempt (Group 1, 80.6% vs. Group 2, 89.5%; P < 0.0001). More lesions under 5 mm were biopsied using FFDM (Group 1, 15%; Group 2, 20.4%; P = 0.008). Accurate preoperative diagnosis of malignancy permitted single-stage surgery in 77.4% Group 2 versus 67.9% Group 1 (P = 0.017). For DCIS cases, similar first-line mastectomy rates were observed (Group 1, 30.3% vs. Group 2, 33.3%, P = NS). Fewer B3/4 lesions upgraded at surgery (Group 1, 48.7% vs. Group 2, 20%; P = 0.011).


Nonoperative work-up of MM using FFDM reduced second therapeutic procedures for MM, decreased upgrade of B3/4 lesions at diagnostic surgery, but increased benign nonoperative biopsies for MM.

Authors’ Affiliations

University Hospital South Manchester
University of Manchester


© Bundred et al.; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.