Intraductal carcinoma; preinvasive or noninvasive cancer
Definitions
Clonal proliferation of malignant epithelial cells originating in terminal duct lobular unit (TDLU) without invasion of myoepithelial layer or basement membrane
Nonobligate precursor to IDC
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Prognostic Tools
Selected References
Parikh U et al: Ductal carcinoma in situ: the whole truth. AJR Am J Roentgenol. 210(2):246-55, 2018
Podoll MB et al: Feasibility of the less is more approach in treating low-risk ductal carcinoma in situ diagnosed on core needle biopsy: ten-year review of ductal carcinoma in situ upgraded to invasion at surgery. Arch Pathol Lab Med. 142(9):1120-26, 2018
Grimm LJ et al: Imaging features of patients undergoing active surveillance for ductal carcinoma in situ. Acad Radiol. 24(11):1364-71, 2017
Grimm LJ et al: Surgical upstaging rates for vacuum assisted biopsy proven dcis: implications for active surveillance trials. Ann Surg Oncol. 24(12):3534-40, 2017
Kuhl CK et al: Impact of preoperative breast MR imaging and MR-guided surgery on diagnosis and surgical outcome of women with invasive breast cancer with and without DCIS component. Radiology. 161449, 2017
Elmore JG et al: Diagnostic concordance among pathologists interpreting breast biopsy specimens. JAMA. 313(11):1122-32, 2015
Kim SY et al: Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS. Ann Surg Oncol. 22(9):2895-901, 2015
Solin LJ et al: Surgical excision without radiation for ductal carcinoma in situ of the breast: 12-year results from the ECOG-ACRIN E5194 study. J Clin Oncol. 33(33):3938-44, 2015
Mun HS et al: Screening-detected calcified and non-calcified ductal carcinoma in situ: differences in the imaging and histopathological features. Clin Radiol. 68(1):e27-35, 2013
Rauch GM et al: Clinicopathologic, mammographic, and sonographic features in 1,187 patients with pure ductal carcinoma in situ of the breast by estrogen receptor status. Breast Cancer Res Treat. 139(3):639-47, 2013
Wang LC et al: US appearance of ductal carcinoma in situ. Radiographics. 33(1):213-28, 2013
Davis KL et al: Use of MRI in preoperative planning for women with newly diagnosed DCIS: risk or benefit? Ann Surg Oncol. 19(10):3270-4, 2012
Deurloo EE et al: MRI of the breast in patients with DCIS to exclude the presence of invasive disease. Eur Radiol. 22(7):1504-11, 2012
Ferris-James DM et al: Imaging approaches to diagnosis and management of common ductal abnormalities. Radiographics. 32(4):1009-30, 2012
Goto M et al: The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy. Eur Radiol. 22(6):1255-64, 2012
Pilewskie M et al: Effect of MRI on the Management of Ductal Carcinoma In Situ of the Breast. Ann Surg Oncol. Epub ahead of print, 2012
Spanu A et al: Breast scintigraphy with breast-specific γ-camera in the detection of ductal carcinoma in situ: a correlation with mammography and histologic subtype. J Nucl Med. 53(10):1528-33, 2012
Suh YJ et al: Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8- or 11-gauge vacuum-assisted biopsy. Br J Radiol. 85(1016):e349-56, 2012
Brennan ME et al: Ductal carcinoma in situ at core-needle biopsy: meta-analysis of underestimation and predictors of invasive breast cancer. Radiology. 260(1):119-28, 2011
Cho N et al: Sonoelastographic lesion stiffness: preoperative predictor of the presence of an invasive focus in nonpalpable DCIS diagnosed at US-guided needle biopsy. Eur Radiol. 21(8):1618-27, 2011
Gwak YJ et al: Ultrasonographic detection and characterization of asymptomatic ductal carcinoma in situ with histopathologic correlation. Acta Radiol. 52(4):364-71, 2011
Hayward L et al: The influence of clinicopathological features on the predictive accuracy of conventional breast imaging in determining the extent of screen-detected high-grade pure ductal carcinoma in situ. Ann R Coll Surg Engl. 93(5):385-90, 2011
Hofvind S et al: Mammographic morphology and distribution of calcifications in ductal carcinoma in situ diagnosed in organized screening. Acta Radiol. 52(5):481-7, 2011
Houssami N et al: Accuracy of a preoperative model for predicting invasive breast cancer in women with ductal carcinoma-in-situ on vacuum-assisted core needle biopsy. Ann Surg Oncol. 18(5):1364-71, 2011
Kim JA et al: MRI findings of pure ductal carcinoma in situ: kinetic characteristics compared according to lesion type and histopathologic factors. AJR Am J Roentgenol. 196(6):1450-6, 2011
Lari SA et al: Biological markers in DCIS and risk of breast recurrence: a systematic review. J Cancer. 2:232-61, 2011
Mossa-Basha M et al: Ductal carcinoma in situ of the breast: MR imaging findings with histopathologic correlation. Radiographics. 30(6):1673-87, 2010. Review. Erratum in: Radiographics. 31(1):316, 2011
Rahbar H et al: Characterization of ductal carcinoma in situ on diffusion weighted breast MRI. Eur Radiol. 21(9):2011-9, 2011
D'Orsi CJ: Imaging for the diagnosis and management of ductal carcinoma in situ. J Natl Cancer Inst Monogr. 2010(41):214-7, 2010
Early Breast Cancer Trialists' Collaborative Group et al: Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. J Natl Cancer Inst Monogr. 2010(41):162-77, 2010
Habel LA et al: Mammographic density and risk of second breast cancer after ductal carcinoma in situ. Cancer Epidemiol Biomarkers Prev. 19(10):2488-95, 2010
Lehman CD: Magnetic resonance imaging in the evaluation of ductal carcinoma in situ. J Natl Cancer Inst Monogr. 2010(41):150-1, 2010
Pisano ED: Mode of detection and secular time for ductal carcinoma in situ. J Natl Cancer Inst Monogr. 2010(41):142-4, 2010
Thomas J et al: Radiological and pathological size estimations of pure ductal carcinoma in situ of the breast, specimen handling and the influence on the success of breast conservation surgery: a review of 2564 cases from the Sloane Project. Br J Cancer. 102(2):285-93, 2010
Virnig BA et al: Ductal carcinoma in situ of the breast: a systematic review of incidence, treatment, and outcomes. J Natl Cancer Inst. 102(3):170-8, 2010
Yamada T et al: Radiologic-pathologic correlation of ductal carcinoma in situ. Radiographics. 30(5):1183-98, 2010
Shin HJ et al: Screening-detected and symptomatic ductal carcinoma in situ: differences in the sonographic and pathologic features. AJR Am J Roentgenol. 190(2):516-25, 2008
Brem RF et al: Detection of ductal carcinoma in situ with mammography, breast specific gamma imaging, and magnetic resonance imaging: a comparative study. Acad Radiol. 14(8):945-50, 2007
Kuhl CK et al: MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 370(9586):485-92, 2007
Lehman CD et al: MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med. 356(13):1295-303, 2007
Al-Attar MA et al: The impact of image guided needle biopsy on the outcome of mammographically detected indeterminate microcalcification. Breast. 15(5):635-9, 2006
Esserman LJ et al: Magnetic resonance imaging captures the biology of ductal carcinoma in situ. J Clin Oncol. 24(28):4603-10, 2006
Weaver DL et al: Pathologic findings from the Breast Cancer Surveillance Consortium: population-based outcomes in women undergoing biopsy after screening mammography. Cancer. 106(4):732-42, 2006
Barreau B et al: Mammography of ductal carcinoma in situ of the breast: review of 909 cases with radiographic-pathologic correlations. Eur J Radiol. 54(1):55-61, 2005
Groves AM et al: Characterization of pure high-grade DCIS on magnetic resonance imaging using the evolving breast MR lexicon terminology: can it be differentiated from pure invasive disease? Magn Reson Imaging. 23(6):733-8, 2005
Harms SE: The use of breast magnetic resonance imaging in ductal carcinoma in situ. Breast J. 11(6):379-81, 2005
Menell JH et al: Determination of the presence and extent of pure ductal carcinoma in situ by mammography and magnetic resonance imaging. Breast J. 11(6):382-90, 2005
Bluemke DA et al: Magnetic resonance imaging of the breast prior to biopsy. JAMA. 292(22):2735-42, 2004
Harris JR et al: Diseases of the Breast. Philadelphia: Lippincott Williams & Wilkins. 521-38, 2004
Moon WK et al: US of ductal carcinoma in situ. Radiographics. 22(2):269-80; discussion 280-1, 2002
Ioffe OB: Local extent of disease: a pathology perspective. Semin Breast Dis. 4:179-90, 2001
Stomper PC et al: Mammographic detection and staging of ductal carcinoma in situ: mammographic-pathological correlation. Semin Breast Dis. 3:26-41, 2000
Fisher B et al: Tamoxifen in treatment of intraductal breast cancer: National Surgical Adjuvant Breast and Bowel Project B-24 randomised controlled trial. Lancet. 353(9169):1993-2000, 1999
Rosen PP: Rosen's Breast Pathology. Philadelphia: Lippincott-Raven. 209-74, 1997
Lev-Toaff AS et al: Stability of malignant breast microcalcifications. Radiology. 192(1):153-6, 1994
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References
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Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
Intraductal carcinoma; preinvasive or noninvasive cancer
Definitions
Clonal proliferation of malignant epithelial cells originating in terminal duct lobular unit (TDLU) without invasion of myoepithelial layer or basement membrane
Nonobligate precursor to IDC
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Prognostic Tools
Selected References
Parikh U et al: Ductal carcinoma in situ: the whole truth. AJR Am J Roentgenol. 210(2):246-55, 2018
Podoll MB et al: Feasibility of the less is more approach in treating low-risk ductal carcinoma in situ diagnosed on core needle biopsy: ten-year review of ductal carcinoma in situ upgraded to invasion at surgery. Arch Pathol Lab Med. 142(9):1120-26, 2018
Grimm LJ et al: Imaging features of patients undergoing active surveillance for ductal carcinoma in situ. Acad Radiol. 24(11):1364-71, 2017
Grimm LJ et al: Surgical upstaging rates for vacuum assisted biopsy proven dcis: implications for active surveillance trials. Ann Surg Oncol. 24(12):3534-40, 2017
Kuhl CK et al: Impact of preoperative breast MR imaging and MR-guided surgery on diagnosis and surgical outcome of women with invasive breast cancer with and without DCIS component. Radiology. 161449, 2017
Elmore JG et al: Diagnostic concordance among pathologists interpreting breast biopsy specimens. JAMA. 313(11):1122-32, 2015
Kim SY et al: Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS. Ann Surg Oncol. 22(9):2895-901, 2015
Solin LJ et al: Surgical excision without radiation for ductal carcinoma in situ of the breast: 12-year results from the ECOG-ACRIN E5194 study. J Clin Oncol. 33(33):3938-44, 2015
Mun HS et al: Screening-detected calcified and non-calcified ductal carcinoma in situ: differences in the imaging and histopathological features. Clin Radiol. 68(1):e27-35, 2013
Rauch GM et al: Clinicopathologic, mammographic, and sonographic features in 1,187 patients with pure ductal carcinoma in situ of the breast by estrogen receptor status. Breast Cancer Res Treat. 139(3):639-47, 2013
Wang LC et al: US appearance of ductal carcinoma in situ. Radiographics. 33(1):213-28, 2013
Davis KL et al: Use of MRI in preoperative planning for women with newly diagnosed DCIS: risk or benefit? Ann Surg Oncol. 19(10):3270-4, 2012
Deurloo EE et al: MRI of the breast in patients with DCIS to exclude the presence of invasive disease. Eur Radiol. 22(7):1504-11, 2012
Ferris-James DM et al: Imaging approaches to diagnosis and management of common ductal abnormalities. Radiographics. 32(4):1009-30, 2012
Goto M et al: The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy. Eur Radiol. 22(6):1255-64, 2012
Pilewskie M et al: Effect of MRI on the Management of Ductal Carcinoma In Situ of the Breast. Ann Surg Oncol. Epub ahead of print, 2012
Spanu A et al: Breast scintigraphy with breast-specific γ-camera in the detection of ductal carcinoma in situ: a correlation with mammography and histologic subtype. J Nucl Med. 53(10):1528-33, 2012
Suh YJ et al: Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 8- or 11-gauge vacuum-assisted biopsy. Br J Radiol. 85(1016):e349-56, 2012
Brennan ME et al: Ductal carcinoma in situ at core-needle biopsy: meta-analysis of underestimation and predictors of invasive breast cancer. Radiology. 260(1):119-28, 2011
Cho N et al: Sonoelastographic lesion stiffness: preoperative predictor of the presence of an invasive focus in nonpalpable DCIS diagnosed at US-guided needle biopsy. Eur Radiol. 21(8):1618-27, 2011
Gwak YJ et al: Ultrasonographic detection and characterization of asymptomatic ductal carcinoma in situ with histopathologic correlation. Acta Radiol. 52(4):364-71, 2011
Hayward L et al: The influence of clinicopathological features on the predictive accuracy of conventional breast imaging in determining the extent of screen-detected high-grade pure ductal carcinoma in situ. Ann R Coll Surg Engl. 93(5):385-90, 2011
Hofvind S et al: Mammographic morphology and distribution of calcifications in ductal carcinoma in situ diagnosed in organized screening. Acta Radiol. 52(5):481-7, 2011
Houssami N et al: Accuracy of a preoperative model for predicting invasive breast cancer in women with ductal carcinoma-in-situ on vacuum-assisted core needle biopsy. Ann Surg Oncol. 18(5):1364-71, 2011
Kim JA et al: MRI findings of pure ductal carcinoma in situ: kinetic characteristics compared according to lesion type and histopathologic factors. AJR Am J Roentgenol. 196(6):1450-6, 2011
Lari SA et al: Biological markers in DCIS and risk of breast recurrence: a systematic review. J Cancer. 2:232-61, 2011
Mossa-Basha M et al: Ductal carcinoma in situ of the breast: MR imaging findings with histopathologic correlation. Radiographics. 30(6):1673-87, 2010. Review. Erratum in: Radiographics. 31(1):316, 2011
Rahbar H et al: Characterization of ductal carcinoma in situ on diffusion weighted breast MRI. Eur Radiol. 21(9):2011-9, 2011
D'Orsi CJ: Imaging for the diagnosis and management of ductal carcinoma in situ. J Natl Cancer Inst Monogr. 2010(41):214-7, 2010
Early Breast Cancer Trialists' Collaborative Group et al: Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. J Natl Cancer Inst Monogr. 2010(41):162-77, 2010
Habel LA et al: Mammographic density and risk of second breast cancer after ductal carcinoma in situ. Cancer Epidemiol Biomarkers Prev. 19(10):2488-95, 2010
Lehman CD: Magnetic resonance imaging in the evaluation of ductal carcinoma in situ. J Natl Cancer Inst Monogr. 2010(41):150-1, 2010
Pisano ED: Mode of detection and secular time for ductal carcinoma in situ. J Natl Cancer Inst Monogr. 2010(41):142-4, 2010
Thomas J et al: Radiological and pathological size estimations of pure ductal carcinoma in situ of the breast, specimen handling and the influence on the success of breast conservation surgery: a review of 2564 cases from the Sloane Project. Br J Cancer. 102(2):285-93, 2010
Virnig BA et al: Ductal carcinoma in situ of the breast: a systematic review of incidence, treatment, and outcomes. J Natl Cancer Inst. 102(3):170-8, 2010
Yamada T et al: Radiologic-pathologic correlation of ductal carcinoma in situ. Radiographics. 30(5):1183-98, 2010
Shin HJ et al: Screening-detected and symptomatic ductal carcinoma in situ: differences in the sonographic and pathologic features. AJR Am J Roentgenol. 190(2):516-25, 2008
Brem RF et al: Detection of ductal carcinoma in situ with mammography, breast specific gamma imaging, and magnetic resonance imaging: a comparative study. Acad Radiol. 14(8):945-50, 2007
Kuhl CK et al: MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 370(9586):485-92, 2007
Lehman CD et al: MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med. 356(13):1295-303, 2007
Al-Attar MA et al: The impact of image guided needle biopsy on the outcome of mammographically detected indeterminate microcalcification. Breast. 15(5):635-9, 2006
Esserman LJ et al: Magnetic resonance imaging captures the biology of ductal carcinoma in situ. J Clin Oncol. 24(28):4603-10, 2006
Weaver DL et al: Pathologic findings from the Breast Cancer Surveillance Consortium: population-based outcomes in women undergoing biopsy after screening mammography. Cancer. 106(4):732-42, 2006
Barreau B et al: Mammography of ductal carcinoma in situ of the breast: review of 909 cases with radiographic-pathologic correlations. Eur J Radiol. 54(1):55-61, 2005
Groves AM et al: Characterization of pure high-grade DCIS on magnetic resonance imaging using the evolving breast MR lexicon terminology: can it be differentiated from pure invasive disease? Magn Reson Imaging. 23(6):733-8, 2005
Harms SE: The use of breast magnetic resonance imaging in ductal carcinoma in situ. Breast J. 11(6):379-81, 2005
Menell JH et al: Determination of the presence and extent of pure ductal carcinoma in situ by mammography and magnetic resonance imaging. Breast J. 11(6):382-90, 2005
Bluemke DA et al: Magnetic resonance imaging of the breast prior to biopsy. JAMA. 292(22):2735-42, 2004
Harris JR et al: Diseases of the Breast. Philadelphia: Lippincott Williams & Wilkins. 521-38, 2004
Moon WK et al: US of ductal carcinoma in situ. Radiographics. 22(2):269-80; discussion 280-1, 2002
Ioffe OB: Local extent of disease: a pathology perspective. Semin Breast Dis. 4:179-90, 2001
Stomper PC et al: Mammographic detection and staging of ductal carcinoma in situ: mammographic-pathological correlation. Semin Breast Dis. 3:26-41, 2000
Fisher B et al: Tamoxifen in treatment of intraductal breast cancer: National Surgical Adjuvant Breast and Bowel Project B-24 randomised controlled trial. Lancet. 353(9169):1993-2000, 1999
Rosen PP: Rosen's Breast Pathology. Philadelphia: Lippincott-Raven. 209-74, 1997
Lev-Toaff AS et al: Stability of malignant breast microcalcifications. Radiology. 192(1):153-6, 1994
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