Name : Maryam
Family : Noori
Affiliation :Teb Azma Imaging Center,Ghom,Iran
Academic Degree : Radiologist
Resident : ------------------
Gender : Female
Age : 51
A 51-year-old woman presented with screening mammogram.
On bilateral MLO & CC mammogram, focal asymmetric density & a cluster of granular microcalcifications are identified in right UOQ near to areolar margin (BIRADS IVc), corresponding lesion was depicted on US & US guided core biopsy was performed.
High grade DCIS (comedo type)
Discussion (Related Text)
Ductal carcinoma insitu (DCIS) represents 25-30% of all reported breast cancers. Approximately 95% of all DCIS is diagnosed because of mammography detected microcalcifications. The morphology of calcifications is the most important factor in the differentiation between benign & malignant. If calcifications cannot be readily identified as typically benign or as high probability of malignancy, they are termed of intermediate concern or suspicious. In distribution of calcifications the forms cluster, linear & segmental are the most important in diagnosis of malignancy. Cluster defines at least 5 calcifications occupy a small volume of tissue (<1cc). Clustered calcifications are both seen in benign & malignant disease and are of intermediate concern. When clusters are scattered throughout the breast this favors a benign entity & a single cluster of calcification favors a malignant entity. There are conflicting data concerning the value of absence of change over time. It said that the absence of interval change in microcalcifications that are probably benign on the basis of morphologic data is a reassuring sign and an indication for continued mammographic follow-up. Based on proved data, it seems that the morphology of calcifications is far more important than stability & stability can only be relied on if calcifications have a probably benign form.
The radiology assistant. Breast section. Robin Smithus & Ruud Pijnappel.