Multimodality Imaging of Ductal Carcinoma In Situ

AbstractPurpose of ReviewWe aim to review the appearance of ductal carcinoma in situ (DCIS) across the spectrum of imaging modalities used in common clinical practice.Recent FindingsChanges in technology and clinical breast cancer screening patterns have impacted the imaging evaluation of DCIS. DCIS classically presents as asymptomatic calcifications in women undergoing screening mammography. The replacement of traditional 2D mammography with digital breast tomosynthesis has changed the typical appearance of screen-detected DCIS. Ultrasound is traditionally utilized to detect DCIS in women with clinical symptoms, but efforts to increase screening ultrasound rates for women with dense breasts makes it more important to identify the appearance of DCIS in asymptomatic women. Improvements in MRI technology have made MRI the most sensitive imaging modality to detect DCIS and define the extent of disease, which is increasingly important given greater utilization of MRI for high-risk screening and determination of extent of known disease. Finally, the emergence of active surveillance, or non-surgical management, for DCIS has increased the focus on presurgical identification of associated invasive cancer, with early results demonstrating promise via computer vision and deep learning approaches for this task.SummaryDCIS has a highly variable imaging appearance which is subject to changes in imaging technology and clinical management.
Source: Current Breast Cancer Reports - Category: Cancer & Oncology Source Type: research

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We present a rare case of Paget disease of the nipple without the typical characteristics, detected by simple nipple scraping technique. A 62-year-old woman presented with a small fissure on the left nipple with scant clear nippledischarge. There were no other changes to the nipple-areola complex. The mammography and ultrasound were unremarkable. However, nipplescraping provided the immediate cytological diagnosis of Paget disease. Breast MRI with core biopsy showed high grade ductal carcinoma in situwith suggestion of microinvasion, confirmed histologically after mastectomy. Nipple scraping is a simple and inexpensive tec...
Source: Dermatology Online Journal - Category: Dermatology Source Type: research
AbstractIntroductionBreast cancer is the most commonly diagnosed female cancer. Diagnosis in younger women (under 35  years) is different to their older counterparts, and mammography is not considered as sensitive in this cohort. Consequentially, younger patients may present later with more advanced disease.MethodsThis is a retrospective analysis of a prospectively updated database containing consecutive patients who presented to the symptomatic breast unit of Galway University Hospital between 2009 and 2015. Patient clinicopathologic factors, clinical examination features, diagnostic radiological modalities and Bi-RA...
Source: Irish Journal of Medical Science - Category: General Medicine Source Type: research
ConclusionsMRI is the best predictor of tumor size in breast cancer. Histologic type and tumor size are key parameters when estimating tumor size and should be taken into account when planning surgery. Patient age does not interfere with the interpretation of imaging tests.ResumenIntroducciónEl objetivo de este estudio fue evaluar qué prueba de imagen de las empleadas para medir el tamaño del cáncer de mama primario preoperatorio (mamografía, ecografía o resonancia magnética (RM)) se correlacionó mejor con el tamaño del tumor en la pieza quirúrgica posto...
Source: Cirugia Espanola - Category: Surgery Source Type: research
CONCLUSIONS: MRI is the best predictor of tumor size in breast cancer. Histologic type and tumor size are key parameters when estimating tumor size and should be taken into account when planning surgery. Patient age does not interfere with the interpretation of imaging tests. PMID: 31186117 [PubMed - as supplied by publisher]
Source: Cirugia eEspanola - Category: Surgery Authors: Tags: Cir Esp Source Type: research
Conclusion: The texture analysis for breast DCE-MRI proposed in this study demonstrated potential utility in HER2 2+ status discrimination. Background Human epidermal growth factor receptor 2 (HER2) is an orphan tyrosine kinase receptor. It is reported that HER2 is overexpressed in 15–20% of breast cancers. Overexpression of HER2 in breast cancer correlates with shortened disease-free survival. Compared with HER2-negative patients, patients with HER2-positive breast cancers have a poor prognosis, a high probability of lymph node metastasis and a high risk of recurrence (1–3). However, previous studies h...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Normally, when a physician notices a suspicious mass or lesion on a mammogram, he or she will request an ultrasound to explore it further. Based on those results, a biopsy may be performed to determine whether the mass is cancerous. “Unfortunately, right now, in some cases, physicians either overdiagnose or underdiagnose based on that biopsy, because with ultrasound they can only see so much,” said Lori Chmura, CEO of Dune Medical Devices. “The doctor is essentially going in blindly, trying to see what looks like the most suspicious area, and they’re t...
Source: MDDI - Category: Medical Devices Authors: Tags: Business Source Type: news
ConclusionsDBT-guided biopsy for architectural distortion detected a malignancy in 19% of lesions, demonstrating the importance of pathologic diagnosis for lesions without correlating ultrasound findings.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
A 47-year-old premenopausal woman with no known family history of breast cancer and an unremarkable medical history presented to her primary care physician after palpating a mass in her left breast. A mammogram and ultrasound demonstrated a 3.2  × 1.3-cm mass at 3 o'clock, 4 cm from the nipple, in her left breast. A biopsy showed invasive ductal carcinoma, intermediate nuclear grade, with associated high-grade ductal carcinoma in situ (DCIS). Estrogen and progesterone receptors stained positive, HER2 was negative by FISH, and Ki67 was 25%.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Gray Zone Source Type: research
This study analyzed data from women over 40 and compared the size of breast cancers at the time of diagnosis detected in the 1970s (before mammography became common) with the size of tumors detected between 2000 and 2002, when screening mammography was routine. Treatments and rates of death due to breast cancer 10 years after the diagnosis were also analyzed. The study found that: As more women underwent routine screening mammograms, more small breast cancers were detected. Many of these tumors were restricted to the ducts within the breast (called ductal carcinoma in situ), and even without treatment would never threaten...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Source Type: blogs
Conclusion: This is the first time breast tomosynthesis was used in galactography (galactomosynthesis) to create digital 3-dimensional images of suspicious findings. When used together with the generated synthetic digital 2D full-field mammograms, it could be a useful complementary procedure for the diagnosis of breast anomalies and could herald a renaissance of this method. Compared with high-resolution ductal ultrasound, the investigators achieved better results with contrast-enhanced galactography using tomosynthesis and the generated synthetic digital 2D full-field mammograms, as confirmed by histopathological findings...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
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