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Screening-Detected and Symptomatic Ductal Carcinoma in Situ: Differences in the Sonographic and Pathologic Features

¹ Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 388-1 Pungnap-dong, Songpa-Gu, Seoul 138-376, Korea.
² Department of Pathology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
³ Department of Radiology, Hanyang University Hospital, College of Medicine, Seoul, Korea.

View larger version (93K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —41-year-old woman with painless palpable mass in left breast. Mammogram shows diffuse, dense parenchymal pattern with no definite focal lesion.

View larger version (107K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —41-year-old woman with painless palpable mass in left breast. Orthogonal sonograms show irregularly shaped, mixed hyper- and hypoechoic lesion (arrows) in left breast. Surgery confirmed intermediate grade papillary ductal carcinoma in situ.

View larger version (100K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —41-year-old woman with painless palpable mass in left breast. Orthogonal sonograms show irregularly shaped, mixed hyper- and hypoechoic lesion (arrows) in left breast. Surgery confirmed intermediate grade papillary ductal carcinoma in situ.

View larger version (96K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —Asymptomatic 44-year-old woman with micropapillary ductal carcinoma in situ (DCIS). Mammogram shows irregularly shaped, high-density mass (arrows) in upper outer quadrant of right breast.

View larger version (142K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —Asymptomatic 44-year-old woman with micropapillary ductal carcinoma in situ (DCIS). Orthogonal sonograms show irregularly shaped, mixed hyper- and hypoechoic mass with indistinct margin (arrows) in right breast.

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —Asymptomatic 44-year-old woman with micropapillary ductal carcinoma in situ (DCIS). Orthogonal sonograms show irregularly shaped, mixed hyper- and hypoechoic mass with indistinct margin (arrows) in right breast.

View larger version (138K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —Asymptomatic 44-year-old woman with micropapillary ductal carcinoma in situ (DCIS). Sonogram shows associated duct dilatation and nodular wall thickening (arrows) in subareolar area of right breast. At surgery, these dilated ducts with intraductal nodules were also involved by DCIS.

View larger version (115K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —Asymptomatic 58-year-old woman with intermediate-grade ductal carcinoma in situ. Mammogram shows oval, isodense mass with pleomorphic microcalcifications (arrows) in left breast.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —Asymptomatic 58-year-old woman with intermediate-grade ductal carcinoma in situ. Sonograms show relatively circumscribed, oval, hypoechoic mass (arrows) with clustered microcalcifications and posterior acoustic shadowing (arrowhead, C) in left breast. Power Doppler study shows no increased vascularity in mass.

View larger version (150K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —Asymptomatic 58-year-old woman with intermediate-grade ductal carcinoma in situ. Sonograms show relatively circumscribed, oval, hypoechoic mass (arrows) with clustered microcalcifications and posterior acoustic shadowing (arrowhead, C) in left breast. Power Doppler study shows no increased vascularity in mass.

View larger version (82K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —Asymptomatic 45-year-old woman with cribriform and papillary ductal carcinoma in situ. Screening mammogram shows multifocal clustered microcalcifications (arrows) in upper outer quadrant of right breast.

View larger version (152K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —Asymptomatic 45-year-old woman with cribriform and papillary ductal carcinoma in situ. Sonogram shows hypoechoic mass (arrows) with clustered microcalcifications and posterior shadowing (arrowhead) in right breast.

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —36-year-old woman with palpable lump in right breast. Mammogram shows multifocal pleomorphic microcalcifications (arrows) and segmental distribution in right upper breast.

View larger version (113K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —36-year-old woman with palpable lump in right breast. Sonogram shows irregularly shaped, mixed hyper- and hypoechoic mass (arrows) in left breast. Nonclustered microcalcifications were detected within and outside mass.

View larger version (116K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —36-year-old woman with palpable lump in right breast. Sonogram shows duct dilatation (arrows) in subareolar area and microcalcifications (arrowheads) around dilated duct.

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