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US of Ductal Carcinoma In Situ¹

¹ From the Departments of Radiology (W.K.M., J.S.M., Y.J.L., J.G.I.), Pathology (I.A.P.), and Surgery (D.Y.N.), Clinical Research Institute, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, Korea, and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea. Recipient of a Certificate of Merit award for an education exhibit at the 2000 RSNA scientific assembly. Received April 27, 2001; revision requested June 6 and received September 6; accepted September 24. Address correspondence to W.K.M. (e-mail: moonwk@radcom.snu.ac.kr).

Little is known about the ultrasonographic (US) features of ductal carcinoma in situ (DCIS) of the breast because this entity usually manifests as pure mammographic calcifications and is rarely evaluated with US. US findings were recorded in 70 patients with DCIS and then analyzed and correlated with mammographic and histologic findings. A microlobulated mass with mild hypoechogenicity, ductal extension, and normal acoustic transmission was the most common US finding in DCIS. Spiculated margins, marked hypoechogenicity, a thick echogenic rim, and posterior acoustic shadowing at US often suggested the presence of invasion. US performed with a 10–13-MHz transducer and optimal technique can be used as a complement to mammography in detecting and evaluating DCIS of the breast, as it demonstrates breast lesions associated with malignant microcalcifications in most cases. The main benefit of identifying a US abnormality in women with mammographically detected DCIS is to allow the use of US to guide interventional procedures (eg, needle biopsy, needle localization). US may also be helpful in detecting DCIS without calcifications and in evaluating disease extent in women with dense breasts. Nevertheless, further research is needed to delineate the role of US in the evaluation of patients with DCIS.

© RSNA, 2002

Index Terms: Breast neoplasms, 00.32 • Breast neoplasms, calcifications, 00.812 • Breast neoplasms, diagnosis, 00.1298 • Breast neoplasms, US, 00.1298

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