Calcified and non-calcified ductal carcinoma in situ: differences in sonographic and pathologic features

Abstract

Objective To compare the sonographic and pathologic features of calcified and non-calcified ductal carcinoma in situ(DCIS). Methods A total of 83 lesions in 82 consecutive patients with pathologically confirmed pure DCIS were recruited. One patient had bilateral lesions. All lesions were divided into calcified DCIS and non-calcified DCIS according to the presence of calcifications on mammography. Their sonographic features and pathologic reports for all patients with DCIS were retrospectively reviewed. Statistical comparisons were performed using the chi-square test. Results (1)Calcified DCIS showed positive ultrasound(US) findings in 80% (44/55)of cases. The most common US finding was nonmass lesions (43.6%, 24/55). Nine cases had pure ductal dilatations(16.4%, 9/55). Non-calcified DCIS showed positive US findings in 96.4% (27/28)of cases.The most common US finding was mass (89.2%, 25/28). Two cases had pure ductal dilatations(7.1%, 2/28). No significant difference was found in the shape, margin, orientation, posterior feature of a mass between the calcified and non-calcified groups (P>0.05). Significant difference was observed in the size, boundary, echogenicity on ultrasound of the two groups (P<0.05). (2)At histopathology, the pathological scores high nuclear grade, positive ER status, positive PR status, positive Ki67 status and the presence of Her-2/neu oncogene were more common in the calcified group than in the non-calcified group. Conclusions Calcified and non-calcified pure DCIS have different pathologic and sonographic features. Calcified DCIS has more aggressive histological features than non-calcified DCIS. Key words: Ultrasonography; Breast neoplasms; Calcification