术前新辅助化疗（NAC）乳腺癌患者的成像指南缺乏对手术规划中各个模式的适用性和效益的具体规定。微小钙化物使乳腺X线摄影术的解读复杂。我们研究了术后微小钙化物的乳腺X线摄影及磁共振成像（MRI）病变的范围和确定性手术病理学之间的相关性。在这个回溯性队列研究中，我们从连续接受NAC的乳腺癌患者数据库中收集了乳腺X线摄影中存在钙化物的患者。主要目标是确定术后钙化物的最大尺寸与手术病理学（浸润性疾病、肿瘤床和导管内癌症[DCIS]）的相关性，并根据肿瘤受体亚组进行分层。其次，我们研究了剩余疾病与MRI质量增强（ME）和非ME的相关性。皮尔森相关系数被用来评估统计学意义（强：R2≥70％;中度：R2=25-70％;弱：R2≤25％）。总体而言，符合纳入标准的患者共有186例。乳腺X线摄影中的钙化与浸润性疾病的相关性很差（R2 = 10.8％），高估了57％。在乳腺X线摄影中存在钙化物的患者中，MRI ME和NME与浸润性疾病和DCIS的最大尺寸之间具有较弱的相关性。在三阴性乳腺癌（TNBC）患者中，浸润性疾病与钙化最大尺寸的相关程度很强（R2 = 83％），与ME（R2 = 37.7％）和NME（R2 = 28.4％）中等强度的相关性。总体而言，目前的成像技术和最终手术病理学之间的相关性很差，高估了手术标本的范围。这种不良相关性可能会导致对所需手术切除范围的不确定性以及在进行中的试验中剔除可能的非手术治疗候选者。鉴于TNBC的病理学和成像之间存在更强的相关性，因此TNBC将成为这些试验的理想候选者。 ©2023年外科肿瘤学会。

Imaging guidelines for post-neoadjuvant chemotherapy (NAC) breast cancer patients lack specificity on appropriateness and utility of individual modalities for surgical planning. Microcalcifications confound mammographic interpretation. We examined the correlation between the mammographic extent of microcalcifications present post-NAC, corresponding magnetic resonance imaging (MRI) lesions, and definitive surgical pathology.In this retrospective cohort study, patients with calcifications on mammography were collected from a database of consecutive breast cancer patients receiving NAC. The primary objective was to determine the correlation between maximum dimension of post-NAC calcifications with surgical pathology (invasive disease, tumor bed, and ductal carcinoma in situ [DCIS]), stratified by tumor receptor subgroup. Secondarily, we examined the correlation of residual disease with MRI mass enhancement (ME) and non-ME (NME). Pearson's correlation coefficient was used to evaluate statistical significance (strong: R2 ≥70%; moderate: R2=25-70%; weak: R2 ≤25%).Overall, 186 patients met the inclusion criteria. Mammographic calcifications correlated poorly with invasive disease (R2 = 10.8%), overestimating by 57%. In patients with calcifications on mammography, MRI ME and NME correlated weakly with the maximum dimension of invasive disease and DCIS. In triple-negative breast cancer (TNBC) patients, invasive disease correlated strongly with the maximum dimension of calcifications (R2 = 83%) and moderately with ME (R2 = 37.7%) and NME (R2 = 28.4%).Overall, current imaging techniques correlate poorly and overestimate final surgical pathology. This poor correlation may lead to uncertainty in the extent of required surgical excision and the exclusion of potential candidates for non-surgical management in ongoing trials. TNBCs would be good candidates for these trials given the stronger observed correlations between pathology and imaging.© 2023. Society of Surgical Oncology.