Yonsei Med J.  2008 Feb;49(1):103-110.

Non-Calcified Ductal Carcinoma in Situ: Ultrasound and Mammographic Findings Correlated with Histological Findings

• Cho KR
• Seo BK
• Kim CH
• Whang KW
• Kim YH
• Kim BH
• Woo OH
• Lee YH
• Chung KB

Abstract

PURPOSE
To evaluate radiological findings of non-calcified ductal carcinoma in situ (DCIS) and to correlate those with histological features. MATERIALS AND METHODS: From July 2002 to March 2006, 22 patients with histologically-proven non-calcified DCIS were included. Mammography was obtained in 19 patients, ultrasound in 18 patients, and both examinations in 15 patients. Radiological findings were evaluated according to the Breast Imaging Reporting and Data System by American College of Radiology. Histological tumor subtype and Van Nuys classification of DCIS were assessed. RESULTS: Histological subtypes consisted of mixed type in 11 patients (50%), comedo in 4 (18%), cribriform in 4 (18%), papillary type in 2 (9%), and solid in one (5%). According to Van Nuys classification, group 3 DCIS was observed in 13 (59%) patients. In the 19 patients who underwent mammography, 13 patients presented with abnormal findings: focal asymmetry in 7 patients (37%), masses in 4 (21%), skin thickening in one (5%), and architectural distortion in one (5%). In the 18 patients who had received breast ultrasound, a mass was present in 15 (83%) patients and ductal changes in 3 patients (17%). Sixty percent of patients with masses on ultrasound had group 3 DCIS and 100% of patients with ductal change had group 1 DCIS (p=0.017). CONCLUSION: Diagnosis of non-calcified DCIS by mammography is not an easy task due to the lack of typical malignant calcifications or masses. High resolution ultrasound can be useful for detecting non-calcified DCIS, and ultrasound findings are correlated with histological features.

Keyword

Breast neoplasms; noninfiltrating intraductal carcinoma; mammography; mammary ultrasonography

MeSH Terms

Adult
Aged
Aged, 80 and over
Breast Neoplasms/metabolism/pathology/*radiography/*ultrasonography
Calcinosis/metabolism/pathology
Carcinoma, Intraductal,
Female
Humans
Mammography
Middle Aged

Figure

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  Fig. 1 (Patient No. 5) A 35-year-old woman with a palpable mass in left breast and group 3 DCIS of Van Nuys classification (A) Mammography shows a focal asymmetry (arrows) in the left upper outer quadrant, palpable mass site. (B) Transverse (left) and longitudinal (right) scans of US reveal a microlobulated marginated, irregular shaped, hypoechoic mass (arrows). The mass has parallel orientation and an unaffected posterior acoustic feature.

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  Fig. 2 (Patient No. 8) A 42 -year-old woman with a palpable mass in the right breast and group 3 DCIS of Van Nuys classification. (A) Right mammography shows no detectable lesion. (B) Transverse scan of US demonstrates an indistinct marginated, oval shaped, hypoechoic mass (arrows) in the lower mid portion of right breast, palpable mass site. The mass has parallel orientation and an unaffected posterior acoustic feature.

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  Fig. 3 (Patient No. 12) A 45-year-old woman with left bloody discharge and group 1 DCIS of Van Nuys classification. (A) Mammography shows no detectable abnormal finding. (B) Transverse scan of US depicts ductectasia with intraductal solid components (arrows) in the central portion of the left breast.

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