Abstract
There are varied mammographic and ultrasonographic manifestations of breast carcinomas that begin in the milk ducts and are confined to the ducts and lobules or penetrated through the duct wall into the stroma. The mammographic findings include focal masses with or without spiculated hyperdense lesion, oval or lobulated shape, various patterns of microcalcifications, asymmetric density, architectural distortion, and associated features such as skin thickening and retraction, nipple retraction, and axillary lymphadenopathy. The ultrasonographic abnormalities include masses (solid or cystic) and their shapes, margins, echo patterns, posterior acoustic features, calcifications, vascularity determined by color Doppler imaging, and effects on surrounding tissue. Radiologists play no role in giving direct pathological reports. Our role is to describe the findings and give an impression of what they look like in terms of Breast Imaging Report and Data System (BIRADS). For any suspected lesion with a chance of malignancy of 2% and above (BIRADS 4 and 5), a pathological study is recommended. For any lesions seen by ultrasonography (US), a US-guided core needle biopsy (CNB) is recommended. For lesions seen only by mammography, stereotactic guidance is appropriate. The image-guided intervention provides the pathological result that is essential for the clinician to plan treatment with the patient. Part 1 of this case report includes DCIS and IDC. The interesting cases are the varieties of presentation, different patterns of imaging findings, CNB results, and finally the surgical pathological results.
Highlights
There are varied mammographic and ultrasonographic manifestations of breast carcinomas that begin in the milk ducts and are confined to the ducts and lobules or penetrated through the duct wall into the stroma
The interesting cases are the varieties of presentation, different patterns of imaging findings, core needle biopsy (CNB) results, and the surgical pathological results
DCIS is the most common type of noninvasive breast cancer, characterized by cancerous cells that are confined to the lining of the milk ducts and have not spread through the duct walls into surrounding breast tissue
Summary
Image-guided tissue sampling has reduced operation time and risks during the frozen section of the incisional biopsy of the breast lesion in the operating room.[11] The breast lesion and the axillary node histology and cytology are known before the operation, this allows the clinician to plan the management with the patient before the operation.[12] If the axillary lymph node is positive, axillary node dissection can be performed with no need for sentinel node study or frozen section. If the specimen contains only fatty tissue or normal fibroglandular tissue, no discrete mass, excisional biopsy is suggested or a repeat CNB, if the image fails to show the cutting chamber is inside the lesion. This part 1 includes DCIS and invasive ductal carcinoma. The interesting cases are the varieties of presentation, different patterns of imaging findings, CNB results and the surgical pathological results
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