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Published on: December 15, 2014
Mammographically non-calcified ductal carcinoma in situ: sonographic features with pathological correlation in 35
B Mesurolle1, M El-Khoury, K Khetani
1Department of Radiology, McGill University, and Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada. bmesurolle@yahoo.fr
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.
