FOCAL AREAS OF INCREASED OPACITY IN DUCTAL CARCINOMA IN-SITU OF THE COMEDO TYPE - MAMMOGRAPHIC-PATHOLOGICAL CORRELATION

PURPOSE: To determine a histopathologic explanation for focal areas of increased opacity on mammograms of ductal carcinoma in situ of the co medo type (comedocarcinoma). MATERIALS AND METHODS: From January 1991 to January 1993, mammograms from 36 patients with comedocarcinomas wer e reviewed. Each mammogram was screened for microcalcifications and/or any focal area of increased opacity. The presence or absence of infil trating components was confirmed at pathologic examination, with parti cular emphasis placed on the search for any stromal reaction. RESULTS: The clinical examination revealed a palpable tumor in five patients ( 14%) and a bloody discharge from the nipple in two (5%). Isolated clus ters of microcalcifications were seen at mammography in 24 patients (6 7%). Nine patients (25%) had clusters associated with focal areas of i ncreased opacity; three patients (8%) had no microcalcifications. Hist ologic analysis demonstrated an intense, periductal, inflammatory reac tion in all 12 patients with focal areas of increased opacity. CONCLUS ION: Focal areas of increased opacity are not always indicative of an infiltrating component and may merely represent intense stromal reacti on.