The detection of ductal carcinoma in situ at mammographic screening enables the diagnosis of small, grade 3 invasive tumours.
This study was carried out to assess the frequency of ductal carcinoma in situ (DCIS) occurring within and surrounding grade 3 invasive tumours and the effect of its detection on size and nodal stage of invasive carcinomas at mammographic detection. Grade 3 tumours with either no associated DCIS or DCIS only within the invasive component were significantly larger in size than tumours with surrounding DCIS (P < 0.02) and were less likely to be under or equal to 10 mm in size (0% or 13% vs 30% respectively, P < 0.02). Tumours with mammographic calcification were more likely to be less than or equal to 10 mm in size than non-calcific tumours (32% vs 11% respectively, P < 0.05). This was because of the high frequency of tumours less than or equal to 10 mm in size in the linear/branching calcification group. Tumours showing calcification without a mass also appear to be a group with good prognostic features, with a mean size of 13 mm, 33% being 10 mm or less in size and only 17% being node positive. We have found that the presence of surrounding DCIS enables earlier detection of grade 3 invasive carcinomas because of the presence of mammographically visible calcification. Detection of calcification suggestive of DCIS should remain an important part of mammographic screening.
Evans
A J
AJ
Department of Radiology, Nottingham City Hospital, UK.
Pinder
S E
SE
Snead
D R
DR
Wilson
A R
AR
Ellis
I O
IO
Elston
C W
CW
D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008327:Mammography