Analysis of Key Radiographic Characteristics of Early Invasive Breast Cancer, Stages T₁ₐ₋bN₀M₀ and DCIS

Relevance: The systematization of radiological signs of microcarcinomas will increase the frequency of detection of the disease at an early stage and maximize the effectiveness of breast cancer treatment.

Purpose: To assess the key radiological characteristics of early forms of breast cancer (invasive tumors up to 1.0 cm and ductal carcinoma in situ).

Material and methods: The key radiological characteristics were studied in 110 patients with verified early forms of breast cancer: ductal carcinoma in situ (DCIS), invasive breast cancer up to 1 cm in size according to the morphological examination of the surgical material in the absence of signs of regional and distant metastasis — stage p T₁ₐ₋_bN₀M₀.

Results: The main radiological signs detected in mammography (MG) in early breast cancer were the nodular mass without microcalcifications — in 26 cases (23.9 %), the nodule and microcalcifications — in 35 cases (32.1 %), in 27 patients (24.8 %) — microcalcifications without a tumor node. In addition, in 17 cases (15.6 %) there was a violation of the architectonics or focal asymmetry, and in 4 patients (3.7 %) no signs of a malignant process were revealed at all with MG. The revealed changes in the breast in most patients (83 cases, 76.1 %) were interpreted as BIRADS 5, which indicates an extremely high probability of the presence of a malignant neoplasm. In 9 cases (8.3 %) after mammography, the diagnosis was interpreted as BIRADS 4, in 16 (14.7 %) cases the category BIRADS 0 was assigned, which required additional examination methods, and only in 1 patient (0.9 %) the revealed changes were interpreted as benign.

Conclusions: Mammography performed in 92 patients (84.4 %), based on the assessment of radiological signs, to establish the BIRADS 4/5 category, which served as the basis for performing a biopsy and verifying the diagnosis. However, in 15 % there were diagnostic difficulties in interpreting the data, which confirms the data of the world literature on the complexity of the differential diagnosis of microcarcinomas. 

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