Comparison of Clinical and Pathologic Characteristics of Ductal Carcinoma in Situ Detected on Mammography versus Ultrasound Only in Asymptomatic Patients

Ultrasound Med Biol. 2019 Jan;45(1):68-77. doi: 10.1016/j.ultrasmedbio.2018.09.003. Epub 2018 Oct 12.

Abstract

The main purpose of this study was to retropectively compare the clinical and pathologic characteristics of ductal carcinoma in situ (DCIS) detected on mammography and ultrasound (US) in asymptomatic patients. From February 2014 to September 2016, 236 asymptomatic patients with primary pure DCIS and dense breasts were included. The patients were classified into two groups. The mammography group (n = 165) included patients with DCIS detected on mammography, and the US group (n = 71) included patients with DCIS detected on US only. Clinicopathologic characteristics were compared between the two groups. Subgroup analyses were performed with a cutoff age of 50 y and a cutoff tumor size of 20 mm. In 236 patients, younger age, smaller tumor size, low nuclear grade, no comedo necrosis and progesterone receptor positivity were observed more in the US group (p < 0.05). HER2 and Ki67 positivity was observed more frequently in the mammography group (p < 0.05). Similar results were obtained in 168 patients with DCIS <20 mm and in patients ≥50 y. In patients <50 y, smaller tumor size, low nuclear grade and no comedo necrosis were observed significantly more often in the US group. DCIS in the US group significantly more often manifested low nuclear grade, no comedo necrosis and hormone receptor positivity, whereas HER2 and Ki67 positivity was observed significantly more often in the mammography group.

Keywords: Asymptomatic; Breast ultrasound; Ductal carcinoma in situ; Mammography; Screening.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Breast / diagnostic imaging
  • Breast / pathology
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging*
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Female
  • Humans
  • Mammography*
  • Middle Aged
  • Reproducibility of Results
  • Retrospective Studies
  • Ultrasonography, Mammary*
  • Young Adult