High detection rate of breast ductal carcinoma in situ calcifications on mammographically directed high-resolution sonography

Objective. To assess the high-frequency sonographic characteristics of duct al carcinoma in situ of the breast. Methods. In a retrospective review, we identified 18 patients with biopsy-proven pure ductal carcinoma in situ who had received mammographic and high-frequency sonographic examinations at t ransducer frequencies of 10 to 13 MHz. Results. Ali 18 patients had mammogr aphically identified calcifications. Four (22%) of the 18 had either asymme tric focal mammographically identified densities or masses with the calcifi cations. These calcifications were identified sonographically in 17 (94%) o f the 18 patients, in 9 (50%) of 18 patients, the calcifications were assoc iated with sonographically detected malignant masses, and in 3 (17%) of 18 patients the calcifications were within focally dilated ducts. Lesions that had masses or dilated ducts visible on sonography represented 9 (82%) of 1 1 of the grade 3 neoplasms and only 2 (28%) of 7 of the grade 1 and 2 tumor s. This difference was statistically significant (P < .039). Conclusions. O ur study showed that ductal carcinoma in situ may appear on sonography as c alcifications, masses, or focally dilated ducts. Those lesions that were as sociated with masses or dilated duels on sonography were more likely high-g rade histologic specimens.