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Review
. 2010;2010(41):214-7.
doi: 10.1093/jncimonographs/lgq037.

Imaging for the diagnosis and management of ductal carcinoma in situ

Carl J D'Orsi  1
Affiliations
Review

Imaging for the diagnosis and management of ductal carcinoma in situ

Carl J D'Orsi. J Natl Cancer Inst Monogr. 2010.

Abstract

Diagnosis of ductal carcinoma in situ (DCIS) has increased dramatically in parallel with the increased use of screening mammography. There are specific mammographic findings, most associated with shapes (amorphous, fine and coarse pleomorphic, and fine linear) and distributions (linear and segmental) of calcifications that permit a reasonable sensitivity for detection of DCIS without an unreasonable decrease in specificity, especially in view of the dramatic decrease in breast cancer mortality associated with early detection. While some DCIS may never progress to invasive disease, at this time, we cannot make that separation. This should be an active area for research.

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Figures

Figure 1
Figure 1
Terminal ductal lobular unit. The basic subgross histological unit in the breast is the terminal ductal lobular unit. There is a terminal duct and a lobule. The lobule is subdivided into acini.
Figure 2
Figure 2
Spot magnification mammogram. The anatomy of the terminal ductal lobular unit is demonstrated on this magnification spot view with the lobule and acini filled with coarse heterogeneous calcifications (large arrow) and the terminal duct filled with linear forms of calcifications (small arrow). Pathology: comedo ductal carcinoma in situ.
Figure 3
Figure 3
Histology of terminal ductal lobular unit.
Figure 4
Figure 4
Spot magnification mammogram. Cluster of amorphous calcifications. Note the hazy appearance of these calcifications. Pathology: cribiform ductal carcinoma in situ.
Figure 5
Figure 5
A) and B) Spot magnification mammograms. Two different patients with a segmental arrangement of fine pleomorphic calcifications. Pathology: comedo ductal carcinoma in situ.
Figure 6
Figure 6
Spot magnification mammography. Cluster of coarse hetereogeneous calcifications. Note size of the individual particles approaching 1 mm (arrow). Pathology: benign fibroadenomatoid change.
Figure 7
Figure 7
Spot magnification mammogram. A segmental arrangement of fine linear calcifications. Pathology: comedo ductal carcinoma in situ.
Figure 8
Figure 8
Spot magnification mammogram. Linear arrangement of punctate calcifications. Pathology: cribiform ductal carcinoma in situ.
Figure 9
Figure 9
Receiver operating characteristic curve.
See this image and copyright information in PMC

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