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Ductal carcinoma in situ in an invasive ductal carcinoma

Case contributed by Garth Kruger
Diagnosis certain

Presentation

Routine screening study

Patient Data

Gender: Female

In the upper breast, overlying the pectoral edge is a small mass with spiculated calcifications. Benign coarse calcifications are seen within the central breast.

Case Discussion

The benign liponecrotic calcifications are no problem. Look at the small focus of DCIS high up projected over the pectoral edge. There is a spiculated subtle mass around the calcifications... this is a small focus of DCIS in a solid IDC.

Train your eyes to run up and down the submammary fat on all 4 views. The "milky way" should be free of masses. Use a wide angle lens when you look at all 4 views before you pull out the 600 mm f2.8. The more I practice, the luckier I get.

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