Focal areas of increased opacity in ductal carcinoma in situ of the comedo type: mammographic-pathologic correlation.
OBJECTIVE
To determine a histopathologic explanation for focal areas of increased opacity on mammograms of ductal carcinoma in situ of the comedo type (comedocarcinoma).


METHODS
From January 1991 to January 1993, mammograms from 36 patients with comedocarcinomas were reviewed. Each mammogram was screened for microcalcifications and/or any focal area of increased opacity. The presence or absence of infiltrating components was confirmed at pathologic examination, with particular emphasis placed on the search for any stromal reaction.


RESULTS
The clinical examination revealed a palpable tumor in five patients (14%) and a bloody discharge from the nipple in two (5%). Isolated clusters of microcalcifications were seen at mammography in 24 patients (67%). Nine patients (25%) had clusters associated with focal areas of increased opacity; three patients (8%) had no microcalcifications. Histologic analysis demonstrated an intense, periductal, inflammatory reaction in all 12 patients with focal areas of increased opacity.


CONCLUSIONS
Focal areas of increased opacity are not always indicative of an infiltrating component and may merely represent intense stromal reaction.
Department of Radiology, Institut Gustave Roussy, Villejuif, France.
K
K
Kinkel
R
R
Gilles
C
C
Féger
J M
JM
Guinebretière
A A
AA
Tardivon
J
J
Masselot
D
D
Vanel
D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002114:Calcinosis / Q000000981:diagnostic imaging; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged