Infiltrating Ductal Carcinoma with Mammographic 'Halo Sign' Correlation with Histopathology

Seo, Jae Seung; Oh, Ki Keun; Son, Hong Ju; Lee, Jei Hee; Kim, Dong Guk; Ryu, Jeong Ah; Kim, Eun Kyung; Chang, So Yong; Jung, Woo Hee; Shin, Hyun Ja

Abstract

PURPOSE: To analyze and correlate mammographic/ sonographic features with pathologic findings in patientswith infiltrative ductal carcinoma with the mammographic 'halo sign'.
MATERIALS AND METHODS
We retrospectivelyreviewed 27 cases of surgically confirmed infiltrative ductal breast carcinoma with the mammographic 'halo sign',analysing the mammographic/sonographic findings, clinical records and pathologic findings.
RESULTS
Twenty-sevenpatients with infiltrating ductal breast carcinoma with the mammographic 'halo sign' were aged 32-72 (mean 49+/-12)years. For periods of between 2 days and 5 months(mean, 1.9 months), all had complained of a palpable mass.Histologic sections indicated parenchymal compression(27/27), microscopic infiltration of tumor margin(11/27) andparenchymal fat compression(15/27), without a true capsule. Infiltrating ductal carcinomas with the mammographic'halo sign' were nuclear grade 1 (17/27) or histologic grade III (14/27). Mammography (complete halo:3;partialhalo:24) showed a round(15/27) or macrolobulated (9/27) mass (size : 2.5+/-1cm) which showed partialspiculation(17/27) or-rarely-calcification(2/27). Sonography revealed a hypoechoic mass with a thinboundary(13/15);in five of these 13 cases, pathologic examination revealed microscopic infiltration of the tumormargin. Bilateral shadowing (8/15), posterior enhancement(13/15), and heterogeneous internal echogenicity(13/15)were also noted on sonography.
CONCLUSION
When correlated with the histopathologic findings, infiltrating ductalbreast carcinoma with the 'halo sign' showed a relatively poor pathologic grade, which is known to be one of theprognostic factors. Surrounding parenchyma and fat compression at the margin of a tumor are considered to be oneof the causes of the mammographic 'halo sign'.