Current issues in the diagnosis of ductal carcinoma in situ: A radiopathological correlation

Authors

DOI:

https://doi.org/10.24265/horizmed.2017.v17n1.100

Keywords:

Ductal carcinoma in situ, Microcalcifications, Mammography, Magnetic resonance imaging, Pathology

Abstract

Ductal carcinoma in situ (DCIS) falls into a heterogeneous group of tumors, whose diagnosis has increased with the use of mammography as screening method. The Van Nuys Prognostic Index, mainly based on histological nuclear grade and presence of necrosis, is the most reproducible histopathological classification system. The most common abnormality observed during a mammography are microcalcifications, which coexist with other lesions such as masses and architectural distortion, and represent low-grade lesions. The initial diagnosis should be performed by anamnesis and a detailed physical examination to help determine the morphostructural characteristics of the lesion. Then an imaging and dynamic approach should be achieved by magnetic resonance imaging (MRI) complemented by immunohistochemistry to characterize the tumor. The presence of morphological segmental distribution is typical of malignancy (DCIS). The kinetics of the lesions using a dynamic MRI varies, with the washout and late enhancement pattern being pathognomonic for DCIS. However, the dynamic pattern seems to be correlated with mammographic findings. Multidetector CT and MRI findings may be useful in combination with breast MRI for preoperative mapping. Nevertheless, there are complementary techniques such as spectroscopy and weighted diffusion that improve the specificity of the MRI and are useful in predicting response to adjuvant chemotherapy. These future applications will improve the ability for early diagnosis and treatment options.

Downloads

Download data is not yet available.

References

Silverstein MJ. Carcinoma Ductal in Situ. Cáncer de Mama. España: Marban; 2014.

Broders AC. Carcinoma in situ contrasted with benign penetrating epithelium. JAMA, 1932; 99:1670-74.

Sumner WE, Koniaris LG, Snell SE, Spector S, Powell J, Avisar E, et al. Results of 23,810 cases of ductal carcinoma in situ. Ann Surg Oncol 2007; 14(5):1638-43.

Powell DE, Stelleing CB. Carcinoma de Mama. Enfermedades de la Mama. España: Mosby-Doyma libros, S.A, 2007:274-5.

Murphy WA, DeSchryver-Kecskemeti K. Isolated clustered microcalcifications in the breast: radiologic-pathologic correlation. Radiology.1978; 127(2):335-41.

Mas J, Balagueró L, De Anta J, et al. Atlas de Patologías: Cancer de Mama. España: Ed Asklepios,2013: 29-35.

Bellahcyene A, Castronovo V. Increased expressions of osteonectin and osteopontin, two bone matrix proteins, in human breast cáncer. Am J Pathol. 1995; 146(1):95-100.

Holland R, Hendriks J. Microcalcifications associated with ductal carcinomain situ: mamographic-pathologic correlation. Sem Pathol, 1994; 11(3):181-92.

Lagios M, Westdahl PR, Margolin FR, Rose MR. Duct carcinoma in situ: relationship of extent of noninvasive disease to the frecuency of occult invasión,multicentricity, lymph node metastases, and shortterm tretment failures. Cancer.1982; 50(7):1309.

Silverstein MJ, Woo C. Carcinoma Ductal in Situ. La Mama. España: Ed Panamericana,2007; 48: 1029-63.

Moriya T, Silverberg S. Intraductal Carcinoma of the breast. Int J Surg Pathol, 1995; 3:83.

Poller D. Ductal Carcinoma in situ breast: a proposal for a new simplified histological classification association between celular proliferation and c-erb-2 protein expression. Mod Pathol, 1995; 7:257.

Silverstein MJ. The University of Southern California/Van Nuys prognostic index for ductal carcinoma in situ of the breast. Am J Surg. 2003;186(4):337-43.

Martinez A, Aparicio I, Hernandez G, Muñoz M, de Santiago J. Factores Pronósticos del Carcinoma Ductal in Situ de mama. España. Rev Chil Obstet Ginecol. 2008; 73(1):35-41.

Cervantes G, Ochoa F, Ocampo R, Erazo A, Escudero P, Rivera H. Tercera Revisión del Consenso Nacional sobre Diagnóstico y Tratamiento del Cáncer Mamario. Ginecol Obstet, Mex. 2008; 78(2):138-50.

Yamada T. Radiologic-pathologic correlation of ductal carcinoma in situ. Radiographics.2010;30(5):1183-98.

Yang TL, Liang HL, Chou CP, Huang JS, Pan HB. The Adjunctive Digital breast tomosynthesis in diagnosis of breast cáncer. Biomed Research International. Brasil. 2013; 597253:7.

Viana AD. Calcificações arredondadas como único achado mamográfico no carcinoma de mama: Correlação mamografiaanatomia patológica. Radiol. Bras.,2005; 38( 3): 163-167.

Vianna AD. Cancerização de lóbulos: correlação de achados mamográficos e histológicos. Radiol Bras. 2011; 5(44): 275–78.

Aibar L, Santalla A, Lopez-Criado MS, González–Pérez I, Calderón MA, Gallo JL, et al. Clasificación Radiológica y Manejo de las lesiones mamarias. Clin Invest Gin Obst, 2011; 38(4):141- 49.

Goldstein NS, Kestin L, Vicini F. Intraductal carcinoma of the breast. Pathologic features associated with local recurrence in patients treated breast-conserving therapy. Am J Surg Pathol. 2000; 24:1058-67.

Coombs JH, Hubbard E. Ductal carcinoma in situ of the breast. Am Surg. 1997; 63:1079-83.

Sekine K, Tsunoda-Shimizu H, Kikuchi M, Saida Y, Kawasaki T, Suzuki K. DCIS showing architectural distortion on the screening mammogram: comparison of mammographic and pathological findings. Breast Cancer. 2007;14(3):281–284.

Barreau B, de Mascarel I, Feuga C, MacGrogan G, Dilhuydy MH, Picot V, et al. Mammography of ductal carcinoma in situ of the breast: review of 909 cases with radiographic-pathologic correlations. Eur J Radiol. 2005;54(1):55–61.

Zuñiga I, Villaseñor-Navarro Y, Pérez-Badillo M, Cruz-Morales R, Pavón-Hernández C, Aguilar-Cortázar L. Breast Magnetic Resonance and its applications. GAMO, 2012; 4(11):268-80.

Kaiser WA. Breast Magnetic Resonance Imaging: Principles and Techiques. Elservier. 2007: 228-235.

Sociedad Española de Radiología Médica. Diagnóstico por la Imagen. Cáncer de Mama. Madrid, Radiologia, 2008;2:5-39.

Mountford C, Lean C, Malycha P, Russell P. Proton spectroscopy provides accurate pathology on biopsy and in vivo. J Magn Reson Imaging. 2006;24(3):459-477.

Herrero J. Resonancia Magnética de mama: estado actual y aplicación clínica. Radiología. 2011;53(1):27-38.

Woo C. CDIS: estudios clínicos y controversias en el tratamiento. Cáncer de mama, Ed Marban. 2014; (1): 298-318.

Torres S, Acevedo JC, Aguirre B, Aliaga N, Cereceda L,Dagnino B. State of the art in breast cáncer diagnosis and treatment. Revista Médica Clínica Las Condes. 2013; 24(4):588-609 http://dx.doi.org/10.1016/S0716-8640(13)70199-8

Price E, Hargreaves J, Lipson J, Sickles E, Brenner J, Lindfors K . The California Breast Density Information Group: A Collaborative Response to the Issues of Breas.

Published

2017-03-30

How to Cite

1.
Calderón N. JM, Febles G. Current issues in the diagnosis of ductal carcinoma in situ: A radiopathological correlation. Horiz Med [Internet]. 2017Mar.30 [cited 2025May2];17(1):57-65. Available from: https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/564

Issue

Section

Review article

Most read articles by the same author(s)