J Korean Soc Radiol.  2016 Jun;74(6):361-364. 10.3348/jksr.2016.74.6.361.

Ductal Carcinoma In Situ within a Fibroadenoma: Microcalcifications Identified on Mammography Play a Crucial Role in Diagnosis

• You JK
• Kim YJ
• Kim B
• Kim EK

• KMID: 2164812
• DOI: http://doi.org/10.3348/jksr.2016.74.6.361

Abstract

Fibroadenoma is a common, benign tumor of the breast, which is rarely associated with an increased risk of carcinoma. We report a case of ductal carcinoma in situ within a fibroadenoma in a 38-year-old woman. The lesion was a 1 cm, circumscribed, ovoid mass with internal calcifications evident on mammography and ultrasound, which is commonly found in fibroadenoma, but the calcifications were fine and linear, which is uncommon. This type of calcification is classified as suspicious by the American College of Radiology Breast Imaging-Reporting And Data System, and it is often correlated with comedo necrosis of ductal carcinoma, and, so, requires immediate pathologic confirmation. In our case, careful analysis of the unusual calcifications led to appropriate intervention and diagnosis. Radiologists should be aware that fibroadenomas can be malignant, and they should look for suspicious microcalcifications within a fibroadenoma.

MeSH Terms

Adult
Breast
Breast Neoplasms
Carcinoma, Ductal*
Carcinoma, Intraductal, Noninfiltrating*
Diagnosis*
Female
Fibroadenoma*
Humans
Information Systems
Mammography*
Necrosis
Ultrasonography

Figure

• 

  Fig. 1 Mammography, magnification view (A: mediolateral oblique view, B: craniocaudal view). A 1-cm, circumscribed, isodense mass with internal fine, linear microcalcifications is evident in the upper medial quadrant of the right breast (arrow).

• 

  Fig. 2 Ultrasound findings. Ultrasound (A: transverse view, B: longitudinal view) shows a circumscribed ovoid mass with internal echogenic dots in the right breast, 6 cm from the nipple.

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  Fig. 3 Microscopic findings of ductal carcinoma in situ within a fibroadenoma. A. Histologic examination shows a well-demarcated fibroadenoma with ductal carcinoma in situ in the lower half (H&E stain, × 12.5). B, C. Comedo-type ductal carcinoma in situ with central necrosis and calcification in a background of hyalinized fibroadenoma. H&E stain, × 40 (B), H&E stain, × 200 (C). H&E = hematoxylin and eosin

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