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Breast Cancer Research

Volume 6 Supplement 1

Symposium Mammographicum 2004

Open Access

How spiculation affects the likelihood of malignancy in screen-detected masses: a review of 974 masses excised in the first 8 years of the East Sussex, Brighton & Hove Breast Screening Service

  • S Horn1,
  • C Zammit1,
  • A Yelland1 and
  • G Rubin2
Breast Cancer Research20046(Suppl 1):P22

Published: 14 July 2004


The presence of spiculation arising from a mass detected at mammography makes malignancy a probable diagnosis. This is confirmed by this review of the first 8 years of screening in East Sussex where only 3.6% of masses with spiculation were benign at excision (24 out of 668), compared with 33.3% of masses without spiculation (102 out of 306).

Methods and results

The mammographic appearances of screen-detected lesions were prospectively recorded at the time of assessment. Features recorded for masses were the presence or absence of spiculation and microcalcification. Those undergoing excision were entered onto the former South East Thames Screening database. The mammographic features and type of lesion are presented in Table 1.

Table 1

Mammographic feature

Number of benign lesions (%)

Number of in situ cancers (%)

Number of invasive cancers (%)


Mass with spiculation and microcalcalcification

7 (4.3)

4 (2.4)

153 (93.3)


Mass with spiculation and no microcalcification

17 (3.4)

4 (0.8)

483 (95.8)


Total with spiculation

24 (3.6)

8 (1.2)

636 (95.2)


Mass without spiculation but with microcalcification

27 (30)

11 (12.2)

52 (57.8)


Mass without spiculation or microcalcification

75 (34.7)

12 (5.6)

129 (59.7)


Total without spiculation

102 (33.3)

23 (7.5)

181 (59.2)


Most of these lesions were excised during the era when we performed fine needle aspiration rather than the core biopsies we use today and it was our policy to excise all mass lesions showing spiculation. The very small number of benign surgical biopsies in this group shows that the policy was justified.

Authors’ Affiliations

Breast Surgical Unit, Royal Sussex County Hospital, Brighton, UK
Breast Assessment Centre, Royal Sussex County Hospital, Brighton, UK


© BioMed Central 2004