Pathologic-radiologic correlations in screen-detected ductal carcinoma in situ of the breast: Findings of the Singapore breast screening project

Mammography detected 34 (25%) cases of ductal carcinoma in situ (DCIS) of t he breast out of a total of 135 cancers diagnosed in 28,231 participating w omen during the Singapore breast screening project. Radiologic findings in these 34 women with DCIS were calcifications only in 25 (74%); mass only in 2 (6%); and mass with calcifications in the remaining 7 (20%) cases. Calci fications were classified mammographically as powderish in 2 (6%), crushed stone-like in 16 (50%) and casting in 14 (44%) cases. Pathologic assessment revealed 11 (32%) cases with pure comedo, 16 (47%) mixed, 3 (9%) cribrifor m, 2 (6%) papillary, 1 (3%) micropapillary and 1 (3%) solid patterns. Histo logic nuclear grade was low in 6 (18%), intermediate in 9 (26%) and high in 19 (56%). Necrosis was observed in 26 (77%) cases and absent in the rest. Pathologic-radiologic correlations yielded a significant association betwee n the mammographic and pathologic lesional size, with the degree of agreeme nt improved when there was histologic necrosis. A trend for radiologic crus hed stone-like and casting-type calcifications to be associated with DCIS w ith necrosis and of higher nuclear grade was noted. (C) 2000 Wiley-Liss, In c.