Imaging of Noncalcified Ductal Carcinoma In Situ
Ductal carcinoma in situ (DCIS) is a commonly encountered malignancy, accounting for approximately 20% of new breast cancer diagnoses in the United States. DCIS is characterized by a proliferation of tumor cells within the terminal duct lobular unit with preservation of the basement membrane. Typica...
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Published in | Journal of clinical imaging science Vol. 11; p. 34 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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16.06.2021
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Abstract | Ductal carcinoma
in situ
(DCIS) is a commonly encountered malignancy, accounting for approximately 20% of new breast cancer diagnoses in the United States. DCIS is characterized by a proliferation of tumor cells within the terminal duct lobular unit with preservation of the basement membrane. Typically nonpalpable and asymptomatic, DCIS is most often detected as calcifications on screening mammography. However, DCIS may also be noncalcified. When compared to calcified DCIS, noncalcified DCIS is more likely to be symptomatic, with patients most often presenting with nipple discharge or a palpable mass. Diagnosing noncalcified DCIS is challenging since it may be occult or subtle on mammography, and ultrasound findings can be nonspecific and may be interpreted as benign fibrocystic changes. In cases with a calcified component of DCIS, the extent of DCIS may be underestimated by mammography because not all involved areas may calcify. Breast magnetic resonance imaging (MRI), although less readily available than mammography and ultrasound, is advantageous in detecting noncalcified DCIS, especially high grade DCIS, which may not develop microcalcifications. MRI relies on abnormal contrast uptake due to tumor vascularity and changes in vessel density and permeability. This pictoral review presents the spectrum of imaging findings of noncalcified DCIS to assist radiologists in accurately detecting and describing its key imaging findings. Utilizing different modalities, we review the differential diagnoses for noncalcified DCIS, show illustrative cases of noncalcified DCIS, and discuss the importance of this entity. |
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AbstractList | Ductal carcinoma
in situ
(DCIS) is a commonly encountered malignancy, accounting for approximately 20% of new breast cancer diagnoses in the United States. DCIS is characterized by a proliferation of tumor cells within the terminal duct lobular unit with preservation of the basement membrane. Typically nonpalpable and asymptomatic, DCIS is most often detected as calcifications on screening mammography. However, DCIS may also be noncalcified. When compared to calcified DCIS, noncalcified DCIS is more likely to be symptomatic, with patients most often presenting with nipple discharge or a palpable mass. Diagnosing noncalcified DCIS is challenging since it may be occult or subtle on mammography, and ultrasound findings can be nonspecific and may be interpreted as benign fibrocystic changes. In cases with a calcified component of DCIS, the extent of DCIS may be underestimated by mammography because not all involved areas may calcify. Breast magnetic resonance imaging (MRI), although less readily available than mammography and ultrasound, is advantageous in detecting noncalcified DCIS, especially high grade DCIS, which may not develop microcalcifications. MRI relies on abnormal contrast uptake due to tumor vascularity and changes in vessel density and permeability. This pictoral review presents the spectrum of imaging findings of noncalcified DCIS to assist radiologists in accurately detecting and describing its key imaging findings. Utilizing different modalities, we review the differential diagnoses for noncalcified DCIS, show illustrative cases of noncalcified DCIS, and discuss the importance of this entity. |
ArticleNumber | 34 |
Author | Whitman, Gary Bragg, Ashley Rauch, Gaiane Huang, Monica Candelaria, Rosalind Santiago, Lumarie Scoggins, Marion Adrada, Beatriz |
Author_xml | – sequence: 1 givenname: Ashley surname: Bragg fullname: Bragg, Ashley organization: Department of Breast Imaging, MD Anderson Cancer Center, Houston, Texas, United States – sequence: 2 givenname: Rosalind surname: Candelaria fullname: Candelaria, Rosalind organization: Department of Breast Imaging, MD Anderson Cancer Center, Houston, Texas, United States – sequence: 3 givenname: Beatriz surname: Adrada fullname: Adrada, Beatriz organization: Department of Breast Imaging, MD Anderson Cancer Center, Houston, Texas, United States – sequence: 4 givenname: Monica surname: Huang fullname: Huang, Monica organization: Department of Breast Imaging, MD Anderson Cancer Center, Houston, Texas, United States – sequence: 5 givenname: Gaiane surname: Rauch fullname: Rauch, Gaiane organization: Department of Breast Imaging, MD Anderson Cancer Center, Houston, Texas, United States – sequence: 6 givenname: Lumarie surname: Santiago fullname: Santiago, Lumarie organization: Department of Breast Imaging, MD Anderson Cancer Center, Houston, Texas, United States – sequence: 7 givenname: Marion surname: Scoggins fullname: Scoggins, Marion organization: Department of Breast Imaging, MD Anderson Cancer Center, Houston, Texas, United States – sequence: 8 givenname: Gary surname: Whitman fullname: Whitman, Gary organization: Department of Breast Imaging, MD Anderson Cancer Center, Houston, Texas, United States |
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References | Cox (10.25259/JCIS_48_2021/ref-5) 2013; 53 Moon (10.25259/JCIS_48_2021/ref-3) 2002; 22 Shehata (10.25259/JCIS_48_2021/ref-2) 2019; 1 Rauch (10.25259/JCIS_48_2021/ref-9) 2013; 139 Su (10.25259/JCIS_48_2021/ref-6) 2017; 24 Visser (10.25259/JCIS_48_2021/ref-4) 2019; 28 Mun (10.25259/JCIS_48_2021/ref-7) 2012; 68 Watanabe (10.25259/JCIS_48_2021/ref-8) 2017; 43 Mossa-Basha (10.25259/JCIS_48_2021/ref-10) 2010; 30 Greenwood (10.25259/JCIS_48_2021/ref-11) 2013; 33 Cho (10.25259/JCIS_48_2021/ref-1) 2008; 49 |
References_xml | – volume: 30 start-page: 1673 year: 2010 ident: 10.25259/JCIS_48_2021/ref-10 article-title: Ductal carcinoma in situ of the breast: MR imaging findings with histopathologic correlation publication-title: Radiographics doi: 10.1148/rg.306105510 contributor: fullname: Mossa-Basha – volume: 22 start-page: 269 year: 2002 ident: 10.25259/JCIS_48_2021/ref-3 article-title: US of ductal carcinoma in situ publication-title: Radiographics doi: 10.1148/radiographics.22.2.g02mr16269 contributor: fullname: Moon – volume: 1 start-page: 166 year: 2019 ident: 10.25259/JCIS_48_2021/ref-2 article-title: Ductal carcinoma in situ: Current concepts in biology, imaging, and treatment publication-title: J Breast Imaging doi: 10.1093/jbi/wbz039 contributor: fullname: Shehata – volume: 68 start-page: e27 year: 2012 ident: 10.25259/JCIS_48_2021/ref-7 article-title: Screening-detected calcified and non-calcified ductal carcinoma in situ: Differences in the imaging and histopathological features publication-title: Clin Radiol doi: 10.1016/j.crad.2012.09.003 contributor: fullname: Mun – volume: 49 start-page: 103 year: 2008 ident: 10.25259/JCIS_48_2021/ref-1 article-title: Non-calcified ductal carcinoma in situ: Ultrasound and mammographic findings correlated with histologic findings publication-title: Yonsei Med J doi: 10.3349/ymj.2008.49.1.103 contributor: fullname: Cho – volume: 28 start-page: 835 year: 2019 ident: 10.25259/JCIS_48_2021/ref-4 article-title: Predictors of an invasive breast cancer recurrence after DCIS: A systematic review and meta-analysis publication-title: Cancer Epidemiol Biomarkers Prev doi: 10.1158/1055-9965.EPI-18-0976 contributor: fullname: Visser – volume: 43 start-page: 918 year: 2017 ident: 10.25259/JCIS_48_2021/ref-8 article-title: Ultrasound image classification of ductal carcinoma in situ (DCIS) of the breast: Analysis of 705 DCIS lesions publication-title: Ultrasond Med Biol doi: 10.1016/j.ultrasmedbio.2017.01.008 contributor: fullname: Watanabe – volume: 33 start-page: 1569 year: 2013 ident: 10.25259/JCIS_48_2021/ref-11 article-title: Ductal carcinoma in situ of the breast: Review of MR imaging features publication-title: Radiographics doi: 10.1148/rg.336125055 contributor: fullname: Greenwood – volume: 24 start-page: 562 year: 2017 ident: 10.25259/JCIS_48_2021/ref-6 article-title: Non-calcified ductal carcinoma in situ of the breast: Comparison of diagnostic accuracy of digital breast tomosynthesis, digital mammography, and ultrasonography publication-title: Breast Cancer doi: 10.1007/s12282-016-0739-7 contributor: fullname: Su – volume: 53 start-page: 437 year: 2013 ident: 10.25259/JCIS_48_2021/ref-5 article-title: Microcalcifications in breast cancer: Lessons from physiological mineralization publication-title: Bone doi: 10.1016/j.bone.2013.01.013 contributor: fullname: Cox – volume: 139 start-page: 639 year: 2013 ident: 10.25259/JCIS_48_2021/ref-9 article-title: Clinicopathologic, mammographic, and sonographic features in 1,187 patients with pure ductal carcinoma in situ of the breast by estrogen receptor status publication-title: Breast Cancer Res Treat doi: 10.1007/s10549-013-2598-7 contributor: fullname: Rauch |
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in situ
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Title | Imaging of Noncalcified Ductal Carcinoma In Situ |
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