0620: Breast Ultrasound of DCIS. Correlation with Mammography, MRI and Pathology

Abstract

Ultrasound(US) performed with a 10-13-MHz transducer and optimal technique can be used as a complement to mammography in detecting and evaluating DCIS of the breast. There are several circumstances in which US may be of benefit in the evaluation of patients with DCIS. First, US can be used to visualize large-size (over 10 mm) clusters of microcalcifications with a high suspicion of malignancy (estimated likelihood of malignancy 75% or higher, using mammographic assessment criteria). The main benefit of identifying a sonographic abnormality in women with mammographically detected microcalcifications is to allow the use of US to guide interventional procedures, such as needle biopsy and needle localization. US-guided procedures are less expensive and faster than stereotactically-guided procedures. In addition, for those institutions that do not have stereotactic equipment, the use of US in selected cases would extend the role of precutaneous biopsy at these sites. US may also be used as a guide to biopsy the invasive component of tumors in patients presented with mammographic microcalcifications. Second, US might be used to increase the specificity of mammography and helps to reduce the number of surgical or core biopsies in women with microcalcifications. Third, US can be used to reveal occult DCIS in patients with dense breasts. A microlobulated mass with mild hypoechogenicity, ductal extension, and normal acoustic transmission was the most common US finding in noncalcified DCIS. Fourth, US can be used to evaluate patients with a nipple discharge when ductography is not possible or indeterminate.