Screening-detected and symptomatic ductal carcinoma in situ: differences in the sonographic and pathologic features.
OBJECTIVE
The purpose of our study was to retrospectively compare the sonographic and pathologic features of screening-detected and symptomatic ductal carcinoma in situ (DCIS).


METHODS
Of 5,790 cases diagnosed as breast cancer at our institution between January 1998 and December 2005, 528 (9.1%) cases were DCIS. We found 106 screening-detected and 125 symptomatic DCIS lesions in 226 patients (age range, 20-77 years; mean age, 47.8 years) who underwent preoperative whole-breast sonography and mammography. Three radiologists reviewed the sonographic features of these 231 cases of DCIS by consensus according to Breast Imaging Reporting and Data System (BI-RADS). The pathologic features were also reviewed. Statistical comparisons were performed using the chi-square test, the Fisher's exact test, and the Mann-Whitney U test.


RESULTS
On sonography, masses (p < 0.001) and associated ductal change (p = 0.019) were more common in symptomatic than in asymptomatic patients. Associated microcalcifications and posterior shadowing were more frequently found in screening-detected than in symptomatic DCIS (p < 0.001). On mammography, microcalcifications were more common in screening-detected than in symptomatic DCIS, and masses were more common in symptomatic than in screening-detected DCIS (p < 0.001). No significant differences were seen in the pathologic features of the two groups.


CONCLUSIONS
Our results showed that differences exist in the sonographic features of screening-detected and symptomatic DCIS. Recognition of the many and varied sonographic appearances of DCIS might be helpful to decrease the false-negative rate of bilateral whole-breast sonography and to detect symptomatic mammographically occult DCIS when we use sonography to supplement mammography.
Shin
Hee Jung
HJ
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 388-1 Pungnap-dong, Songpa-Gu, Seoul 138-376, Korea.
Kim
Hak Hee
HH
Kim
Sun Mi
SM
Kwon
Gui Young
GY
Gong
Gyungyub
G
Cho
On Koo
OK
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000706:statistics & numerical data*; D044584:Carcinoma, Ductal / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000706:statistics & numerical data*