Non-Calcified Ductal Carcinoma in Situ: Ultrasound and Mammographic Findings Correlated with Histological Findings
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: To evaluate radiological findings of non-calcified ductal carcinoma in situ (DCIS) and to correlate those with histological features. Materials and Methods: From July 2002 to March 2006, 22 patients with histologically-proven non- calcified DCIS were included. Mammography was obtained in 19 patients, ultrasound in 18 patients, and both examinations in 15 patients. Radiological findings were evaluated according to the Breast Imaging Reporting and Data System by American College of Radiology. Histological tumor subtype and Van Nuys classification of DCIS were assessed. Results: Histological subtypes consisted of mixed type in 11 patients (50%), comedo in 4 (18%), cribriform in 4 (18%), papillary type in 2 (9%), and solid in one (5%). According to Van Nuys classification, group 3 DCIS was observed in 13 (59%) patients. In the 19 patients who underwent mammography, 13 patients presented with abnormal findings: focal asymmetry in 7 patients (37%), masses in 4 (21%), skin thickening in one (5%), and architectural distortion in one (5%). In the 18 patients who had received breast ultrasound, a mass was present in 15 (83%) patients and ductal changes in 3 patients (17%). Sixty percent of patients with masses on ultrasound had group 3 DCIS and 100% of patients with ductal change had group 1 DCIS (p=0.017). Conclusion: Diagnosis of non-calcified DCIS by mammography is not an easy task due to the lack of typical malignant calcifications or masses. High resolution ultrasound can be useful for detecting non-calcified DCIS, and ultrasound findings are correlated with histological features.
Abstract
Purpose: To evaluate radiological findings of non-calcified ductal carcinoma in situ (DCIS) and to correlate those with histological features. Materials and Methods: From July 2002 to March 2006, 22 patients with histologically-proven non- calcified DCIS were included. Mammography was obtained in 19 patients, ultrasound in 18 patients, and both examinations in 15 patients. Radiological findings were evaluated according to the Breast Imaging Reporting and Data System by American College of Radiology. Histological tumor subtype and Van Nuys classification of DCIS were assessed. Results: Histological subtypes consisted of mixed type in 11 patients (50%), comedo in 4 (18%), cribriform in 4 (18%), papillary type in 2 (9%), and solid in one (5%). According to Van Nuys classification, group 3 DCIS was observed in 13 (59%) patients. In the 19 patients who underwent mammography, 13 patients presented with abnormal findings: focal asymmetry in 7 patients (37%), masses in 4 (21%), skin thickening in one (5%), and architectural distortion in one (5%). In the 18 patients who had received breast ultrasound, a mass was present in 15 (83%) patients and ductal changes in 3 patients (17%). Sixty percent of patients with masses on ultrasound had group 3 DCIS and 100% of patients with ductal change had group 1 DCIS (p=0.017). Conclusion: Diagnosis of non-calcified DCIS by mammography is not an easy task due to the lack of typical malignant calcifications or masses. High resolution ultrasound can be useful for detecting non-calcified DCIS, and ultrasound findings are correlated with histological features.
참고문헌 (21)
- Dershaw DD, "Ductal carcinoma in situ: mammographic findings and clinical implications", Radiology, 170, pp.411~415 (1989)
- Holland R, "Schuurmans Stekhoven JH. Extent, distribution, and mammographic", histological correlations of breast ductal carcinoma in situ, 1990, pp.335, 519~522
- Schnitt SJ, "Ductal carcinoma in situ (intraductal carcinoma) of the breast", N Engl J Med, 318, pp.898~903 (1988)
- Stomper PC, "Ductal carcinoma in situ of the breast: correlation between mammographic calcification and tumor subtype", AJR Am J Roentgenol, 159, pp.483~485 (1992)
- Ernster VL, "Mortality among women with ductal carcinoma in situ of the breast in the population-based surveillance, epidemiology and end results program", Arch Intern Med, 160, pp.953~958 (2000)
- Ikeda DM, "Ductal carcinoma in situ: atypical mammographic appearances", Radiology, 172, pp.661~666 (1989)
- Stomper PC, "Clinically occult ductal carcinoma in situ detected with mammography: analysis of 100 cases with radiologic- pathologic correlation", Radiology, 172, pp.235~241 (1989)
- Holland R, "Ductal carcinoma in situ: a proposal for a new classification", Semin Diagn Pathol, 11, pp.167~180 (1994)
- Berg WA, "Multicentric and multifocal cancer: whole-breast US in preoperative evaluation", Radiology, 214, pp.59~66 (2000)
- Crystal P, "Using sonography to screen women with mammographically dense breasts", AJR Am J Roentgenol, 181, pp.177~182 (2003)
- Kaplan SS, "Clinical utility of bilateral whole-breast US in the evaluation of women with dense breast tissue", Radiology, 221, pp.641~649 (2001)
- Leconte I, "Mammography and subsequent whole-breast sonography of nonpalpable breast cancers: the importance of radiologic breast density", AJR Am J Roentgenol, 180, pp.1675~1679 (2003)
- Stavros AT, "Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions", Radiology, 196, pp.123~134 (1995)
- DiPiro PJ, "Image-guided core breast biopsy of ductal carcinoma in situ presenting as a non-calcified abnormality", Eur J Radiol, 30, pp.231~236 (1999)
- Moon WK, "US of ductal carcinoma in situ", Radiographics, 22, pp.269~280 (2002)
- American College of Radiology, "BI-RADS Committee. ACR BI-RADSⓇ breast imaging and reporting data system: breast imaging atlas. Reston" (2003), American College of Radiology
- Consensus Conference Committee, "Consensus conference on the classification of ductal carcinoma in situ", Hum Pathol, 28, pp.1221~1225 (1997)
- Poller DN, "Ideas in pathology. Ductal carcinoma in situ of the breast: a proposal for a new simplified histological classification association between cellular proliferation and c-erbB-2 protein expression", Mod Pathol, 7, pp.257~262 (1994)
- Silverstein MJ, "Prognostic classification of breast ductal carcinoma-in-situ", Lancet, 345, pp.1154~1157 (1995)
- Holland R, "Microcalcifications associated with ductal carcinoma in situ: mammographic-pathologic correlation", Semin Diagn Pathol, 11, pp.181~192 (1994)
- Yang WT, "Sonographic, mammographic, and histopathologic correlation of symptomatic ductal carcinoma in situ", AJR Am J Roentgenol, 182, pp.101~110 (2004)