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Calcium Deposits on Breast Cancer Tumors May Determine Survival (dateline February 10, 2000)

A preliminary study conducted by a team of international researchers reveals that women who have calcium deposits ( calcifications) on their small breast tumors may be at greater risk of dying of breast cancer and should be given more aggressive treatment than women whose tumors do not contain calcifications. On the flip side, women whose tumors do not contain calcifications may be able to safely avoid more aggressive therapies, such as chemotherapy, according to the researchers.

In a study of 343 breast cancer patients, women were divided into sub-groups depending on their tumor size and number of calcium deposits. The researchers discovered that women who had calcium deposits on their tumors had a 55% chance of surviving over 20 years compared with a 95% survival rate for women without calcium deposits. In reaching their conclusions, the researchers analyzed data from the women’s mammograms; breast tumors ranged from one to 14 millimeters in size (all early stage cancers). The pattern of the calcifications seen on the mammogram films was tree-like, branching along the milk ducts of the breast. Researchers called this type of calcium formation, "casting-type calcifications."

Though the research must be confirmed in future studies, Dr. Laszlo Tabar of the Falun Central Hospital in Sweden and lead author of the study said the research indicates the need for physicians to re-evaluate their methods of treating early stage breast cancer. Presently, women with very small breast tumors (less than 15 millimeters in diameter) are usually treated with chemotherapy or other anti-cancer drugs. Some women experience harsh side effects to these therapies, including hair loss and nausea. Women who do not have calcium deposits on their tumors may not need to undergo these aggressive treatments.

On the other hand, women whose tumors do contain calcium deposits may increase their chances of long-term survival if they undergo chemotherapy and other aggressive therapies such as breast surgery with a wider margin of breast tissue taken from around the tumor. Though the scientists’ suggestions are controversial, researcher Robert Smith, PhD said that the study at least indicates a need for further research of breast tumor calcifications. William Wood, MD, chairman of the department of surgery at Emory University, said it is premature to call the study a finding; it is a hypothesis.

Currently, the average survival rate for early stage breast cancer is high (98% to 100% after five years), but researchers hope the study will contribute to even better long-term survival rates, once women who may need more aggressive therapies have been identified. The study also emphasizes that annual mammograms are essential for women over 40 years of age. Women at high risk of the disease (such as those who have BRCA1 or BRCA2   gene mutations) should talk to their physician about beginning mammograms at an earlier age, as early age 25 in some cases. Mammography is the only breast imaging exam approved by the U.S. Food and Drug Administration (FDA) to screen for breast cancer. Mammography is excellent at showing microcalcifications and helps identify breast tumors at an early stage when they are more likely to be successfully eliminated. 

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