Ultrasonography.  2018 Oct;37(4):307-314. 10.14366/usg.17039.

Ultrasonographic features of pure ductal carcinoma in situ of the breast: correlations with pathologic features and biological markers

Affiliations
  • 1Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea. ywchang@schmc.ac.kr
  • 2Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
  • 3Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea.

Abstract

PURPOSE
The purpose of this study was to evaluate the ultrasonographic features of pure ductal carcinoma in situ (DCIS) of the breast and to evaluate the correlations of ultrasonographic features with pathologic and biological features.
METHODS
A total of 141 lesions in 138 women with pure DCIS who underwent preoperative breast ultrasonography were retrospectively reviewed. Ultrasonographic features were analyzed using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) ultrasonography lexicon and the diagnostic criteria of the Japan Society of Ultrasonics in Medicine. Pathologic features including the nuclear grade and presence of comedonecrosis were evaluated. Biological markers including estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) status, as well as the Ki-67 index, were recorded. Ultrasonographic features were compared with pathologic findings and biological markers using the chi-square test. P-values of < 0.05 were considered to indicate statistical significance.
RESULTS
Of the 141 lesions, 75 (53.2%) were mass lesions, 56 (39.7%) were non-mass lesions, and 10 (7.1%) were not visible. The most common feature of the mass pattern was a mass with irregular shape (32.6%), an indistinct margin (27.7%), and hypoechogenicity (37.6%). Microcalcifications were observed in 48 cases (36.6%) as an associated feature. Calcifications outside of a mass were more common than calcifications within a mass. Ultrasonographic microcalcifications and ductal changes were frequently observed in non-mass lesions. Ultrasonographic non-mass lesions were associated with high-grade DCIS (P=0.004) and the presence of comedonecrosis (P=0.006). Microcalcifications were significantly associated with high-grade DCIS (P < 0.001), the presence of comedonecrosis (P < 0.001), an elevated Ki-67 (P < 0.001), and HER2 positivity (P=0.003).
CONCLUSION
The most common ultrasonographic feature of pure DCIS was an irregular, hypoechoic mass with an indistinct margin. Ultrasonographic microcalcifications and ductal changes were more frequent in non-mass lesions, which were correlated with poor prognostic factors, such as a high nuclear grade, comedonecrosis, HER2 positivity, and an elevated Ki-67 index.

Keyword

Breast; Ductal carcinoma in situ; Ultrasonography; Pathology; Biological markers

MeSH Terms

Biomarkers*
Breast*
Carcinoma, Ductal*
Carcinoma, Intraductal, Noninfiltrating*
Estrogens
Female
Humans
Information Systems
Japan
Pathology
Receptor, Epidermal Growth Factor
Receptors, Progesterone
Retrospective Studies
Ultrasonics
Ultrasonography
Ultrasonography, Mammary
Biomarkers
Estrogens
Receptor, Epidermal Growth Factor
Receptors, Progesterone
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