Keywords:
Breast, Ultrasound, Mammography, MR, Biopsy, Cancer
Authors:
E. Horvath, J. A. Cacho, C. Darrás Ismael, C. Silva, M. Gallegos, M. A. Pinochet, M. E. Droguett, E. Soto, H. Wenzel; Santiago/CL
DOI:
10.1594/ecr2018/C-1195
Results
Of a total of 467 operated breast cancers,
41 cases of pure DCIS were identified (8,7%),
11 of them (26.8%) presented as a mass on either US or mammography.
Two cases (22.2%) were US-only lesions.
Mammography
Images were available for 9 out of 11 patients.
In two cases studies were normal.
Masses were detected in 4 patients (44.4%),
most frequently associated with microcalcifications (3 cases).
The remaining cases presented as microcalcifications,
isolated in 2 cases and associated with a focal asymmetry in 1 case.
Ultrasound
In US 6/11 (54,5%) presented as low/intermediate suspicion masses (BI-RADS 4a and 4b).
The usual presentation was an irregular (9/11),
non-circumscribed (10/11),
hypechogenic mass (10/11),
usually with associated microcalcifications (6/11) and vascularized at Doppler imaging (6/11).
The most common MRI appearance was as non-mass-like enhancement in six cases (54.5%).
Histopathologic Findings
Ten nodular pure DCIS (90.9%) had intermediate or high nuclear grade; 10 (90.9%) had necrosis,
4 (36.3%) of them were comedo type.
80% expressed estrogen receptors,
60% progesterone receptors,
and 40% were Her2 positive.
Microscopic analysis showed massive distention of the mammary ducts with neoplastic cells,
that coalesced giving a nodular appearance.