[Microcalcifications in the diagnosis and follow-up after the primary chemotherapy of breast neoplasms].

Since 1998, at the National Cancer Institute (Milan, Italy), a study has been carried on relative to primary chemotherapy for locally advanced breast cancers (greater than 3 cm diameter). Aim of the study is to obtain tumor reduction and thus allow a conservative treatment to be performed. The measures of the two greatest diameters of the tumor by means of mammography, at diagnosis and after chemotherapy, are important parameters for treatment planning. Among the 213 patients who completed the whole diagnostic-therapeutic procedures by December 1990, the authors chose 94 cases (44%) presenting breast cancers with microcalcifications and reviewed the relative mammograms. The review was aimed at analyzing morphology, number and extent of the microcalcifications and at assessing their value as reliable parameters of cancer response to primary chemotherapy. In their experience, the authors found that increased visibility of the microcalcifications after chemotherapy is often due to a reduction in both edema and lesion opacity. On the contrary, fewer microcalcifications may be correlated with incisional diagnostic biopsies. In conclusion, if microcalcifications are a useful parameter for diagnosis, they alone are less important when evaluating response to primary chemotherapy, since they probably represent a permanent sign of the extent of the primary lesion. All follow-up mammograms of the patients who underwent conservative surgery were also reviewed: no residual microcalcifications or other suspicious abnormalities were observed.