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Imaging DCIS: Digital/Film-Screening Mammography, Tomosynthesis, MRI, Ultrasonography

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Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer

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Abstract

Ductal carcinoma in situ (DCIS) can be visualized by multiple imaging modalities including mammography, digital breast tomosynthesis (DBT), ultrasound, and breast magnetic resonance imaging (MRI). It can manifest as a mass or architectural distortion; however, it most commonly presents as suspicious calcifications. Fine linear or fine linear branching calcifications in a segmental distribution have the highest risk of malignancy. Most mammographic calcifications are benign; however, those which are malignant are usually associated with DCIS. The transition from film screen to digital mammography has resulted in an increase in the diagnosis of DCIS because of digital mammography’s higher detection rate for calcifications.

The addition of DBT to digital mammography does not appear to increase the detection of DCIS. The detection of calcifications has been shown to be slightly better with digital mammography than with DBT. The morphology of calcifications is not as well visualized with DBT.

The ultrasound (US) findings of DCIS are nonspecific and often subtle. The most common US finding of DCIS is a mass. Although US is less sensitive than mammography for detecting calcifications, malignant calcifications are more often visualized than those located in benign tissue.

MRI is the most sensitive method for detecting DCIS; however, its main disadvantage is the high false-positive rate. The most common appearance of DCIS on MRI is nonmass enhancement with a clumped internal enhancement pattern. The kinetic curve for DCIS is usually typical for malignancy with a rapid initial enhancement with a delayed plateau phase being most common. DCIS can also have a benign-appearing curve; therefore, imaging interpretation should be based mainly on the morphology of the lesion.

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Authors and Affiliations

  1. Department of Radiology, University of Michigan Health System, Taubman Center, 1500 East Medical Center Drive, 48109, Ann Arbor, MI, USA

    Annette Ingram Joe MD

  2. Department of Radiology, University of Michigan Health System, Med Inn Building, 1500 East Medical Center Drive, 48109, Ann Arbor, MI, USA

    Stephanie K. Patterson MD

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Correspondence to Annette Ingram Joe MD .

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Editors and Affiliations

  1. Comprehensive Cancer Center, University of Michigan Health System, Ann Arbor, Michigan, USA

    Lisa A. Newman

  2. Comprehensive Cancer Center, University of Michigan Health System, Ann Arbor, Michigan, USA

    Jessica M. Bensenhaver

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Joe, A., Patterson, S. (2015). Imaging DCIS: Digital/Film-Screening Mammography, Tomosynthesis, MRI, Ultrasonography. In: Newman, L., Bensenhaver, J. (eds) Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2035-8_3

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  • DOI: https://doi.org/10.1007/978-1-4939-2035-8_3

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