Ductal carcinoma in situ (DCIS)

Case contributed by Dr Garth Kruger

Presentation

Woman presenting for routine screening mammogram.

Patient Data

Age: 40 years
Gender: Female

Microcalcifications are found extending in a radial fashion in the upper outer quadrant of the right breast. The magnified views are very suggestive of DCIS (later confirmed histologically).

Ultrasound of the area showing a solid component.

Case Discussion

This case represents histologically confirmed ductal carcinoma in situ (DCIS) with invasive ductal carcinoma (IDC) component as suspected on the ultrasound images. 

In this case, the DCIS component is actually much larger than suggested on the initial mammogram. The actual extent was from the nipple radially into the periphery of the breast. The extent of the calcifications is underestimated in most cases. The microcalcifications of DCIS are sometimes incorrectly referred to as "amorphous". This means without shape or form. However, the calcifications have both shape and form and are heterogeneous, not amorphous.

It is therefore essential to do an ultrasound during the workup of microcalcifications of the breast.

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