Abstract
Despite the high prevalence of mammographic calcifications, our understanding remains limited regarding the clinical and molecular features of calcifications within triple-negative breast cancer (TNBC). To investigate the clinical relevance and biological basis of TNBC with calcifications of high suspicion for malignancy, we established a study cohort (N = 312) by integrating mammographic records with clinical data and genomic, transcriptomic, and metabolomic profiling. Despite similar clinicopathological features, patients with highly suspicious calcifications exhibited a worse overall survival than those without. In addition, TNBC with highly suspicious calcifications was characterized by a higher frequency of PIK3CA mutation, lower infiltration of immune cells, and increased abnormality of lipid metabolism. Overall, our study systematically revealed clinical and molecular heterogeneity between TNBC with or without calcifications of high suspicion for malignancy. These data might help to understand the clinical relevance and biological basis of mammographic calcifications.