Ductal carcinoma in situ

Case contributed by Garth Kruger

Presentation

Routine mammogram study.

Patient Data

Age: Adult
Gender: Female
mammography

Single benign lobular calcifications and not anything else of note.

One year later

mammography

Developing heterogeneous microcalcifications deep and lateral to the areola and in the deep central parenchyma.

mammography

Mag view shows the heterogeneous nature of the calcifications.

x_ray

Specimen radiograph showing the mammotome clip and localization wires of the sample.

Six months later

Annotated image

Follow up 6 months later. Note the surgical clip and the small area of fat necrosis adjacent to the clip. There is now a developing group of heterogeneous calcifications laterally in the right breast (arrowed) highly suggestive of a developing DCIS focus. If you refer back to the initial image this area was clear of microcalcifications.

Case Discussion

The calcifications of DCIS underestimate the extent of disease. The importance of clear surgical margins is illustrated in this case. Note how the calcifications run almost to the margin of the specimen radiograph at the 2 o'clock radian.

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