title: Screening-detected and symptomatic ductal carcinoma in situ: differences in the sonographic and pathologic features.
abstract: 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.
authors.affiliation: 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.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Shin
authors.forename: Hak Hee
authors.initials: HH
authors.lastname: Kim
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kim
authors.forename: Gui Young
authors.initials: GY
authors.lastname: Kwon
authors.forename: Gyungyub
authors.initials: G
authors.lastname: Gong
authors.forename: On Koo
authors.initials: OK
authors.lastname: Cho
mesh_terms: 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*