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There are varied mammographic and ultrasonographic manifestations of breast carcinomas that begin in the milk ducts and are confined to the ducts and lobules or penetrated through the duct wall into the stroma. The mammographic findings include focal masses with or without spiculated hyperdense lesion, oval or lobulated shape, various patterns of microcalcifications, asymmetric density, architectural distortion, and associated features such as skin thickening and retraction, nipple retraction, and axillary lymphadenopathy. The ultrasonographic abnormalities include masses (solid or cystic) and their shapes, margins, echo patterns, posterior acoustic features, calcifications, vascularity determined by color Doppler imaging, and effects on surrounding tissue. Radiologists play no role in giving direct pathological reports. Our role is to describe the findings and give an impression of what they look like in terms of Breast Imaging Report and Data System (BIRADS). For any suspected lesion with a chance of malignancy of 2% and above (BIRADS 4 and 5), a pathological study is recommended. For any lesions seen by ultrasonography (US), a US-guided core needle biopsy (CNB) is recommended. For lesions seen only by mammography, stereotactic guidance is appropriate. The image-guided intervention provides the pathological result that is essential for the clinician to plan treatment with the patient. Part 1 of this case report includes DCIS and IDC. The interesting cases are the varieties of presentation, different patterns of imaging findings, CNB results, and finally the surgical pathological results.
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2. Mada T, Mori N, Watanabe M et-al. Radiologic- pathologic correlation of ductal carcinoma in situ. Radiographics.2010;30 (5): 1183-98. doi:10.1148/rg. 305095073 - Pubmed citation
3. Statistics from HRH Breast Centre, and Department of Radiology, Siriraj Hospital Medical School, March 2000, July 2004 and May 2005 Analyses.
4. Stavros AT, Thickman D, Rapp CL, et al. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 1995; 196:123–34
5. Evidence Based Benefits and Drawbacks of Breast US in Asian- Women: Wilaiporn Bhothisuwan. Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.In WFUMB 2009, Sydney Australia.
6. Kim CH, Bassett LW. Imaging – guided core needle biopsy of the breast. In Bassett LW, et al. Ed.
7. Staging with Sonography: Gary J Whitman, MD Anderson CancerCenter, Houston, TX, USA. In WFUMB 2009, Sydney Australia.
8. Mc Combs MM , Bassett LW, De Bru hl N ,et al .Imaging-guided needle biopsy of the breast. In Bassett LW et al, Ed. Diagnosis of Diseases of the Breast, Philadelphia, WB Saunders Company 1997: 251-62
9. Reynold HE, Jacksor VP. Sonographically guided interventional procedures. In Bassette LW, et al. Diagnosis of Diseases of the Breast, Philadephia, WB Saunder Company 1997: 263-74.
10. Bhothisuwan W. Breast imaging and intervention. In Adul Ratanawichitrasin ed. Head, Neck & Breast Surgery. Bangkok,SiamSilp Printing 2004;3:41-52.
11. Bhothisuwan W. Core Needle Biopsy of Breast Lesions. InSurapongs Supaporn et al ed. Breast Cancer, Bangkok,Pimdee Press, 1999:105-21.
12. Bhothisuwan W. Breast imaging and intervention. In KitiJindavichak ed.: Breast Cancer, Bangkok, Bangkok Vechakarn 2002:5-18.
13. ACR-BIRADS-US, First Edition: Tom Stavros. Sutter North Bay Women’s Health Center, Santa Rosa, CA, USA. In
WFUMB 2009, Sydney Australia.