DCIS breast - extent of disease

Case contributed by Dr Garth Kruger

Presentation

Preoperative localization of confirmed DCIS right breast

Patient Data

Age: adult
Gender: Female
Ultrasound

The patient has confirmed DCIS. We were asked to bracket the tumor with needles properatively. The ultrasound images below show the DCIS. The margins of the soft tissue density on ultrasound were used to place the wires. 

The mammogram image below shows how much more soft tissue abnormality there is in DCIS than calcification. Soft tissue element and the calcifications therein are visible.

Mammography

After ultrasound guided Kopans wire placement CC view obtained

The wires are well clear of the apparent margins of calcifications. 

Case Discussion

Mammography generally underestimates the degree of DCIS if we go by the calcifications only.

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