DCIS extensively in the right breast
Diagnostic mammogram in a 60 year old lady. CC image right breast.
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This lady had a huge mass in the right breast occupying most of the substance of the breast.
The markings are a left over from analogue imaging and indicate a large cyst centrally in the breast.
This case illustrates how extensive DCIS can be. In this case the calcifications occupy the whole breast. Remember DCIS calcification underestimates the extent of disease. Do not be phased if the disease this extensive; the individual calcifications are still suspicious when looked individually.
Remember: segmental distribution limited to a segment of the breast or a quadrant is a red flag.
Always do ultrasound and see if there is a solid component. I am happy to biopsy these calcifications if they are found on ultrasound, using ultrasound guidance. If you are careful and meticulous about technique, you can on occasion find DCIS even in small volumes.