Cho Kyu Ran, Seo Bo Kyoung, Kim Chul Hwan, Whang Kyu Won, Kim Yun Hwan, Kim Baek Hyun, Woo Ok Hee, Lee Young Hen, Chung Kyoo Byung
Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, 516 Gosan-dong, Danwon-gu, Ansan city, Gyeonggi-do 425-707, Korea.
Yonsei Med J. 2008 Feb 29;49(1):103-10. doi: 10.3349/ymj.2008.49.1.103.
To evaluate radiological findings of non-calcified ductal carcinoma in situ (DCIS) and to correlate those with histological features.
From July 2002 to March 2006, 22 patients with histologically-proven non-calcified DCIS were included. Mammography was obtained in 19 patients, ultrasound in 18 patients, and both examinations in 15 patients. Radiological findings were evaluated according to the Breast Imaging Reporting and Data System by American College of Radiology. Histological tumor subtype and Van Nuys classification of DCIS were assessed.
Histological subtypes consisted of mixed type in 11 patients (50%), comedo in 4 (18%), cribriform in 4 (18%), papillary type in 2 (9%), and solid in one (5%). According to Van Nuys classification, group 3 DCIS was observed in 13 (59%) patients. In the 19 patients who underwent mammography, 13 patients presented with abnormal findings: focal asymmetry in 7 patients (37%), masses in 4 (21%), skin thickening in one (5%), and architectural distortion in one (5%). In the 18 patients who had received breast ultrasound, a mass was present in 15 (83%) patients and ductal changes in 3 patients (17%). Sixty percent of patients with masses on ultrasound had group 3 DCIS and 100% of patients with ductal change had group 1 DCIS (p = 0.017).
Diagnosis of non-calcified DCIS by mammography is not an easy task due to the lack of typical malignant calcifications or masses. High resolution ultrasound can be useful for detecting non-calcified DCIS, and ultrasound findings are correlated with histological features.
评估非钙化性导管原位癌（DCIS）的影像学表现，并将其与组织学特征相关联。
纳入2002年7月至2006年3月间22例经组织学证实的非钙化性DCIS患者。19例患者进行了乳腺钼靶检查，18例患者进行了超声检查，15例患者接受了两种检查。根据美国放射学会的乳腺影像报告和数据系统评估影像学表现。评估DCIS的组织学肿瘤亚型和范努伊斯分类。
组织学亚型包括混合型11例（50%）、粉刺型4例（18%）、筛状型4例（18%）、乳头型2例（9%）和实性型1例（5%）。根据范努伊斯分类，13例（59%）患者为3组DCIS。在19例接受乳腺钼靶检查的患者中，13例有异常表现：7例（37%）为局灶性不对称，4例（21%）为肿块，1例（5%）为皮肤增厚，1例（5%）为结构扭曲。在18例接受乳腺超声检查的患者中，15例（83%）有肿块，3例（17%）有导管改变。超声检查发现有肿块的患者中60%为3组DCIS，有导管改变的患者中100%为1组DCIS（p = 0.017）。
由于缺乏典型的恶性钙化或肿块，通过乳腺钼靶诊断非钙化性DCIS并非易事。高分辨率超声有助于检测非钙化性DCIS，且超声表现与组织学特征相关。
