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AJR Am J Roentgenol. 2008 Feb;190(2):516-25. doi: 10.2214/AJR.07.2206.

Screening-detected and symptomatic ductal carcinoma in situ: differences in the sonographic and pathologic features.

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  • 1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 388-1 Pungnap-dong, Songpa-Gu, Seoul 138-376, Korea.



The purpose of our study was to retrospectively compare the sonographic and pathologic features of screening-detected and symptomatic ductal carcinoma in situ (DCIS).


Of 5,790 cases diagnosed as breast cancer at our institution between January 1998 and December 2005, 528 (9.1%) cases were DCIS. We found 106 screening-detected and 125 symptomatic DCIS lesions in 226 patients (age range, 20-77 years; mean age, 47.8 years) who underwent preoperative whole-breast sonography and mammography. Three radiologists reviewed the sonographic features of these 231 cases of DCIS by consensus according to Breast Imaging Reporting and Data System (BI-RADS). The pathologic features were also reviewed. Statistical comparisons were performed using the chi-square test, the Fisher's exact test, and the Mann-Whitney U test.


On sonography, masses (p < 0.001) and associated ductal change (p = 0.019) were more common in symptomatic than in asymptomatic patients. Associated microcalcifications and posterior shadowing were more frequently found in screening-detected than in symptomatic DCIS (p < 0.001). On mammography, microcalcifications were more common in screening-detected than in symptomatic DCIS, and masses were more common in symptomatic than in screening-detected DCIS (p < 0.001). No significant differences were seen in the pathologic features of the two groups.


Our results showed that differences exist in the sonographic features of screening-detected and symptomatic DCIS. Recognition of the many and varied sonographic appearances of DCIS might be helpful to decrease the false-negative rate of bilateral whole-breast sonography and to detect symptomatic mammographically occult DCIS when we use sonography to supplement mammography.

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