Ductal carcinoma in situ: atypical mammographic appearances

The authors retrospectively analyzed the mammograms of 190 women with biopsy-proved ductal carcinoma in situ (DCIS). Excluded from the current study were 117 (62%) women whose radiographs showed suspicious clustered microcalcifications, a well-known finding in DCIS. Of the remaining 73 (38%) women, 30 (16%) had negative mammograms, and 43 (23%) had mammographic manifestations of breast malignancy other than microcalcifications. Of the latter 43, 15 had circumscribed masses, and 12 had various focal nodular patterns. The remaining 16 patients showed other mammographic signs of malignancy, including asymmetry (n = 1); dilated retroareolar ducts (n = 2); ill-defined, rounded tumor (n = 2); focal architectural distortion (n = 4); subareolar mass (n = 3); and developing density (n = 4). Of the 73 women in the study, 60 presented with clinical findings related to the tumor. Since DCIS has a high survival rate with proper treatment, radiologists should be aware of the unusual radiographic manifestations of this disease.