Learning objectives
To review and describe the morphologic and radiologic features of ductal carcinoma in situ at ultrasound and mammography.
To describe the kinetic of enhancement patterns and kinetic patterns on dynamic contrast-enhanced MRI of breast and diffusion-weighted sequences.
To focus on pathologic correlation.
Background
Ductal carcinoma in situ (DCIS) is the proliferation of tumor cells within the terminal ductal lobular unit with preservation of the basement membrane.
DCIS has been classified according to architectural pattern (solid,
cribriform,
papillary,
micropapillary,
and comedo-type),
tumor grade (high,
intermediate,
and low),
and the presence or absence of necrosis.
DCIS is a heterogeneous disease process,
ranging from low-grade lesions that are not life threatening to high-grade lesions that may harbor foci of invasive disease,
with varied clinical manifestations and a broad spectrum of imaging...
Imaging findings OR Procedure details
Mammographic Finding in DCIS
The most common mammographic finding in DCIS is the presence of heterogeneous or fine pleomorphic calcifications with linear-branching pattern.
DCIS also may manifest as a mass or architectural distortion.
A low-grade lesion without necrosis is less likely to manifest with calcifications than either an intermediate or a high-grade lesion.
The extent of DCIS involvement is frequently underestimated at mammography.
Ultrasound (US) Findings
The US features of DCIS can be subtle and nonspecific.
When calcifications are identified at mammography,
US can be...
Conclusion
DCIS is a heterogeneous disease process that can have a variable appearance.
The most frequnte presentation are the pleomorphyc microcalcifications with ductal distribution.
A hypoechoic mass with non-circumscribed margins,
parallel orientation,
and normal acoustic transmission is the most common US finding in DCIS.
In the setting of calcified DCIS,
US is helpful in evaluating for a possible invasive component and in guiding biopsy.
Noncalcified DCIS may be identified in the evaluation of a mammographic mass or asymmetry,
in symptomatic patients,
at high-risk screening US,
or...
References
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