Mammographically non-calcified ductal carcinoma in situ: sonographic features with pathological correlation in 35 patients

Mesurolle, B.; El-Khoury, M.; Khetani, K.; Abdullah, N.; Joseph, L.; Kao, E.

doi:10.1016/j.crad.2008.12.013

« Previous Next »Clinical Radiology
Volume 64, Issue 6 , Pages 628-636, June 2009

Mammographically non-calcified ductal carcinoma in situ: sonographic features with pathological correlation in 35 patients

B. Mesurolle
- Department of Radiology, McGill University, and Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada
- Guarantor and correspondent: B. Mesurolle, Department of Radiology, McGill University Health Center, Royal Victoria Hospital, 1650 Cedar Avenue, Montreal, PQ, H3G 1A4, Canada. Tel.: +1 514 934 1934x37602; fax: +1 514 934 8263.
M. El-Khoury
- Department of Radiology, McGill University, and Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada
K. Khetani
- Department of Pathology, Cedar Breast Clinic, McGill University, and Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada
N. Abdullah
- Department of Radiology, McGill University, and Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada
L. Joseph
- Department of Epidemiology and Biostatistics, McGill University, and Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada
E. Kao
- Department of Radiology, McGill University, and Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada

Received 24 March 2008; received in revised form 8 December 2008; accepted 22 December 2008.

Aim

To present the sonographic findings of mammographically non-calcified ductal carcinoma in situ (DCIS) with histopathologic correlation.

Materials and methods

The mammographic and ultrasonographic presentations of 47 radiographically non-calcified DCIS lesions in 35 patients were retrospectively analysed. Histological characteristics (architectural appearance, nuclear grade, percent of involved lobules, and presence of necrosis) were reviewed.

Results

Seventeen lesions were not mammographically visible (17/47, 36%). Ultrasonographically, these lesions showed an irregular shape (28/47, 60%), microlobulated margins (34/47, 72%) and abrupt interfaces (42/47, 90%). Only 11% (5/47) displayed posterior shadowing. The echotexture of these lesions was most frequently complex (29/47, 62%); therefore, they were divided into two types: type I (24 cases), which were predominantly solid with cystic components, and type II (five cases), which were predominantly cystic with a solid intra-cystic component. A trend to have greater than 50% DCIS cells in cancerous lobules was observed in masses displaying type I echotexture (difference=36%, 95% confidence interval 10.6–62.5) and microlobulated margins (difference=32%, 95% confidence interval 5.1–58.7).

Conclusion

Ultrasonographically detected radiographically non-calcified DCIS commonly displays an irregular shape, microlobulated margins, and complex echotexture, giving a “pseudomicrocystic” appearance. Microlobulated margins and “pseudomicrocystic” echotexture seem to be associated with a cancerization of the lobules.