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CentraHealth/Virginia Baptist Hospital Lynchburg, VA University of North Carolina at Chapel Hill Chapel Hill, NC

 
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We appreciate Drs. D'Orsi and Hall's comments regarding our alleged disregard for the BI-RADS lexicon in our recent AJR article [1]. We applaud the arduous and long-standing efforts of both these physicians to bring standardization to the description of the mammographic features of breast lesions. However, we encourage Drs. D'Orsi and Hall to more closely inspect the structure, purpose, and language of our article. We sought to test whether the stellate category of small breast cancers had a better prognosis than others. Perhaps we could have been clearer in the wording of the Objective statement. However, in the last paragraph on page 30 we do state that "The study design focused on prognostic categories composed of already diagnosed cases of breast cancer with certain mammographic features" [1].

Each of these categories includes multiple BI-RADS-described features of breast cancers (e.g., see the second paragraph on page 31, lines 5-23) [1]. For example, the stellate prognostic category includes spiculated masses, architectural distortion, and focal asymmetry but excludes any of those lesions if there are associated calcifications. The structure of the study and naming of the categories follow previous investigators' published works [2-4] so that comparisons readily can be made with our own. We feel indeed complimented that such august academicians as Drs. D'Orsi and Hall had no additional negative criticism of our article aside from the semantic one.

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1. Alexander MC, Yankasas BC, Biesemier KW. Association of stellate mammographic pattern with survival in small invasive breast tumors. AJR 2006; 187:29 -37[Abstract/Free Full Text]
2. Tabar L, Chen HH, Duffy SW, et al. A novel method for prediction of long-term outcome of women with T1a, T1b, and 10-14 mm invasive breast cancers: a prospective study. Lancet2000; 355:429 -433[Medline]
3. Thurfjell E, Thurfjell M, Lindgren A. Mammographic finding as predictor of survival in 1-9 mm invasive breast cancers: worse prognosis for cases presenting as calcifications alone. Breast Cancer Res Treat 2001; 67:177 -180[CrossRef][Medline]
4. Zunzunegui RG, Chung MA, Oruwari J, Golding D, Marchant DJ, Cady B. Casting-type calcifications with invasion and high-grade ductal carcinoma in situ: a more aggressive disease? Arch Surg2003; 138:537 -540[Abstract/Free Full Text]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Alexander, M. C. Articles by Yankaskas, B. C. Search for Related Content PubMed Articles by Alexander, M. C. Articles by Yankaskas, B. C. Social Bookmarking                      What's this?