No abstract available.
Breast* ; Carcinoma, Intraductal, Noninfiltrating* ; Fibroadenoma*

No abstract available.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating*

PURPOSE: To compare the mammographic features and histologic subtypes of ductal carcinoma in situ(DCIS) of the breast. MATERIALS AND METHODS: Mammograms of 34 patients with DCIS of the breast detected between January 1992 and November 1998 were retrospectively analyzed. Histologic subtypes were classified as either comedo or noncomedo. Mammographic findings were classified in one of four ways : microcalcification only, microcalcification with mass, mass or asymmetrical density only, or normal. Microcalcifications was classified as either predominantly casting or granular. We also determined whether microcalcification was multifocal. RESULTS: Histologic examination revealed the comedo type in eight patients and the noncomedo type in 26. Among the eight comedo-type cases, mammography demonstrated microcalcification only in five and micro-calcification with mass in three. Among 26 noncomedo-type cases, microcalcifications only was seen in ten, microcalcification with mass in two, mass or asymmetrical density only in six, and normal features in eight. Six of the comedo type were predominantly casting and two were predominantly granular. Predominantly casting calcification was present in four of 12 cases of the noncomedo type and predominatly granular was in eight. Multifocality was seen in four comedo-type cases, but in none of those that were of the noncomedo type. CONCLUSION: We conclude that the comedo subtype of DCIS of the breast is more likely than the noncomedo subtype to be accompanied by microcalcification of the predominantly casting type. Multifocally located microcalcification is a more frequent feature of the comedo subtype than of the noncomedo subtype.
Breast ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Mammography ; Retrospective Studies

Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%. According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification* ; Netherlands

PURPOSE: To verify the role of additional sonography on routine mammograms in the diagnosis of ductal carcinoma in situ (DCIS). MATERIALS AND METHODS: Between 2005 and 2008, a total of 105 breasts belonging to 102 patients were diagnosed with DCIS by surgery. Preoperative ultrasound and mammographic findings and reports using BI-RADS were retrospectively reviewed and analyzed. In both mammogram and ultrasound, BI-RADS categories 1, 2, and 3 were regarded as negative results and categories 4 and 5 as positive results. We analyzed the frequency in which additional ultrasound examinations aided in the diagnosis in each mammographic finding. RESULTS: Out of the 105 cases, 96 showed positive results on a mammogram and 9 cases showed negative results. Clustered microcalcifications, positive mammographic findings, were found most often (64/96, 66.67%). In those cases, ultrasound examinations gave no additional information, but did enablesonographically-guided biopsies in 38. In the 32 cases with other positive mammographic findings, ultrasound examinations were helpful in 15 cases. Of the 9 cases showing negative results on a mammogram, 8 cases were correctly diagnosed with DCIS because of the additionally-performed ultrasound examination, but 1 case returned a false negative on both the mammogram and ultrasound examination. CONCLUSION: Additional sonography contributes to a diagnosis of DCIS in patients with negative mammographic findings, nonspecific mammographic findings, or multifocal lesions.
Biopsy ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Retrospective Studies

PURPOSE: Architectural distortion is a suspicious abnormality for the diagnosis of breast cancer. The aim of this study was to investigate the clinical significance of sonographically detected architectural distortion. MATERIALS AND METHODS: From January 2006 to June 2008, 20 patients were identified who had sonographically detected architectural distortions without a history of trauma or surgery and abnormal mammographic findings related to an architectural distortion. All of the lesions were pathologically verified. We evaluated the clinical and pathological findings and then assessed the clinical significance of the sonographically detected architectural distortions. RESULTS: Based on the clinical findings, one (5%) of the 20 patients had a palpable lump and the remaining 19 patients had no symptoms. No patient had a family history of breast cancer. Based on the pathological findings, three (15%) patients had malignancies. The malignant lesions included invasive ductal carcinomas (n = 2) and ductal carcinoma in situ (n = 1). Four (20%) patients had high-risk lesions; atypical ductal hyperplasia (n = 3) and lobular carcinoma in situ (n = 1). The remaining 13 (65%) patients had benign lesions, however, seven (35%) out of 13 patients had mild-risk lesions (three intraductal papillomas, three moderate or florid epithelial hyperplasia and one sclerosing adenosis). CONCLUSION: Of the sonographically detected architectural distortions, 35% were breast cancers or high-risk lesions and 35% were mild-risk lesions. Thus, a biopsy might be needed for an architectural distortion without an associated mass as depicted on breast ultrasound, even though the mammographic findings are normal.
Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Humans ; Hyperplasia ; Mammography ; Papilloma, Intraductal

Purpose: To analyze the mammographic findings of extensive intraductal compenent (EIC)-positive early invasive breast carcinoma and to determine the mammographic features which predict an EIC positivity in aninvasive carcinoma. MATERIALS AND METHODS: The mammographic and pathologic findings in 71 patients aged 34 -79 (mean 50) years in whom stage I or II invasive breast carcinoma had been diagnosed were etrospectively analysed. The m a mmographic findings were assigned to one of three groups: mass, mass with microcalcification, or microcalci-fication only. The shape and distribution of a calcification were classified according to the BI-RADS TMl exicon, and its extent was classified as either more or less than 3cm. To detect the presence or absence of EIC and the type of ductal carcinoma in situ (DCIS), the findings were reexamined by means of slide mappings. Results: Twenty-eight of 71 patients (39%) showed EIC positivity. The mammographic findings of EIC-posi-tive invasive cancer (n=28) were mass with microcalcification (n=14), microcalcification only (n=7) and mass only (n=7). The mammographic finding which predicted EIC positivity was mass with microcalcification (P-PV: 0.67, NPV: 0.33, p=0.02). A mammographic of mass only (n=39) showed a significantly high negative predictive value for EIC positivity. (PPV 0.18, NPV 0.82, p<0.01). A comparison of cases with or without calci-fication showed that those with microcalcifications (n=32) showed a significantly high PPV of 0.66 (NPV: 0.34, p<0.01 ) while those without calcification (n=39) showed a significantly high NPV of 0.82 (PPV:0.18, p<0.01 ). There were no significant differences in positive predictive values for EIC between the shape, distribution and extent of calcifications. Conclusion: Whenever microcalcification with or without mass is seen on mammograns obtained during early breast cancer, we can predict EIC-positivity, regardless of shape or distribution according to the BI-RADS TM lexicon.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mammography

PURPOSE: To evaluate the results of mammography and ultrasound-guided localization biopsy of nonpalpable lesions, and the differences between them. MATERIALS AND METHODS: Between January 1999 and December 2000, localization biopsies of 441 nonpalpable breast lesions were performed immediately after preoperative localization using a wire hook. Localization was mammography guided in 241 cases and ultrasound guided in 200. The former group included clustered microcalcifications( 195/241, 80.9%), mass (22/241,9.1%) and mass with microcalcifications (24/241, 10.0%), while the latter were almost all mass, or mass with microcalcifications (198/200, 99%). Only two lesions (1%) showed clustered microcalcifications only, and these were previously demonstrated at mammography. RESULTS: Overall, 68 lesions (15.4%) were confirmed as malignancy. Forty-six of 241 mammography guided localization biopsies indicated malignancy: there were 28 noninvasive carcinomas (60.9%), 25 ductal cancers in situ (DCIS), one DCIS combined with lobular cancer in situ (LCIS), and two DCIS combined with microinvasion. Twenty-two of 200 ultrasound-guided localization biopsies revealed malignancy; five such lesions (22.7%) were noninvasive carcinomas. CONCLUSION: The malignancy rate and proportion of noninvasive breast cancers indicated by mammography and ultrasound-guided localization biopsy differed, and this was because the former involved mainly microcalcifications and the latter, masses.
Biopsy* ; Breast Neoplasms ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Mammography* ; Ultrasonography

Stereotactic vacuum-assisted breast biopsy (VAB) has been used to evaluate microcalcifications or non-palpable breast lesions on mammography. Although stereotactic VAB is usually performed in a prone or upright position, an expensive prone table is necessary and vasovagal reactions often occur during the procedure. For these reasons, the lateral decubitus position can be applied for stereotactic VAB, and true lateral mammography can be used to detect the lesion. We report on 15 cases of lateral decubitus positioning for stereotactic VAB with true lateral mammography for non-palpable breast lesions or microcalcifications. The mean procedure time was approximately 30.1 minutes, and no complications occurred during the procedures. Fourteen cases had benign breast lesions and one case had a ductal carcinoma in situ. The lateral decubitus stereotactic VAB with true lateral mammography can be applied for microcalcifications or non-palpable breast lesions and helps to minimize anxiety and vasovagal reactions in patients.
Anxiety ; Biopsy ; Breast ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mammography ; Stereotaxic Techniques

Pigmented mammary Paget disease (PMPD) is a rare subtype of mammary Paget disease that presents as a hyperpigmented patch or plaque over the areola and nipple. We herein report on an unusual case of PMPD with reticulated features in a 98-year-old female. The histology showed intraepidermal pagetoid cells containing melanin pigments without any underlying intraductal carcinoma.
Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Melanins ; Nipples ; Paget's Disease, Mammary