Ductal Carcinoma in Situ

Article

A 57-year-old patient presents for evaluation of right nipple discomfort. The patient has family history of a mother and sister with premenopausal breast cancer.

Clinical History

A 57-year-old patient presents for evaluation of right nipple discomfort. The patient has family history of a mother and sister with premenopausal breast cancer.

Findings

Digital mammography shows area of calcifications (Figure 1a-b). Magnification views demonstrate intraductal pleomorphic microcalcifications in the right 11:00 area (Figure 1c).

No noted findings on physical exam or ultrasound.

Diagnosis

Vacuum assisted stereotactic needle core biopsy of the right breast 11:00 microcalcifications reveals ductal carcinoma in situ.

MRI imaging performed for extent of disease demonstrates linear beaded enhancement extending from nipple posteriorly for 8cm within the right breast upper outer quadrant (Figure 2a-b).
 

Discussion

This case demonstrates the benefit of multimodality imaging including digital mammography and breast magnetic resonance imaging (MRI) in this patient, which led to a diagnosis of ductal carcinoma in situ (DCIS). There has been some conflicting information in the literature regarding MRI and its usefulness in the evaluation of DCIS. For this patient, the MRI revealed the extensive area of involvement more so than mammography. This information was critical to the surgeon for surgical planning.

This article was originally published at Diagnostic Imaging

Recent Videos
Breast oncologist Jade E. Jones, MD, says she tries to send patients with BRCA-mutant HR-positive TNBC to clinical trials that use PARP inhibitors.
Following progression on a CDK4/6 inhibitor, ascertaining the endocrine sensitivity of HR-positive/HER2-negative disease may inform sequential treatment.
T-DXd improved progression-free survival over standard chemotherapy among patients with HR-positive/triple-negative breast cancer in DESTINY-Breast04.
The use of chemotherapy trended towards improved recurrence-free intervals in older patients with high-risk tumors as determined via the MammaPrint assay.
Use of a pharmacist-directed resource appears to improve provider confidence and adverse effect monitoring for patients undergoing infusion therapy.
Reshma L. Mahtani, DO, describes how updates from the DESTINY-Breast09, ASCENT-04, and VERITAC-2 trials may shift practices in the breast cancer field.