Lesion size is a major determinant of the mammographic features of ductal carcinoma in situ: findings from the Sloane project

Lesion size is a major determinant of the mammographic features of ductal carcinoma in situ: findings from the Sloane project
A. Evans, K. Clements, A. Maxwell, H. Bishop, A. Hanby, G. Lawrence, S.E. Pinder
Clinical Radiology 2010 65;3:181-184

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Lesion size has a strong influence on the radiological features of calcific DCIS; small, high-grade lesions often show no casting calcifications, whereas casting calcifications are seen in nearly half of large, low-grade lesions. As small clusters of punctate or granular calcifications may represent high-grade DCIS, an aggressive clinical approach to the diagnosis of such lesions is recommended as the adequate treatment of high-grade DCIS will prevent the occurrence of potentially life-threatening high-grade invasive disease

Mammographically non-calcified ductal carcinoma in situ: sonographic features with pathological correlation in 35 patients

Mammographically non-calcified ductal carcinoma in situ: sonographic features with pathological correlation in 35 patients
B. Mesurolle, M. El-Khoury, K. Khetani, N. Abdullah, L. Joseph, E. Kao
Clinical Radiology 64( 6) 2009: 628-636

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Ultrasonographically detected radiographically non-calcified DCIS commonly displays an irregular shape, microlobulated margins, and complex echotexture, giving a “pseudomicrocystic” appearance. Microlobulated margins and “pseudomicrocystic” echotexture seem to be associated with a cancerization of the lobules

Prediction of the presence of invasive disease from the measurement of extent of malignant microcalcification on mammography and DCIS

Prediction of the presence of invasive disease from the measurement of extent of malignant microcalcification on mammography and ductal carcinoma in situ grade at core biopsy
E.A.M. O'Flynn, J.C. Morel, J. Gonzalez, N. Dutt, D. Evans, R. Wasan, M.J. Michell
Clinical Radiology 64, Issue 2, February 2009, Pages 178-183

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Risk of invasion associated positively with -

increased cluster size

Cluster size DCIS (mm)	Total cases	Invasive cases	Non-invasive cases
<11	136	27 (20%)	109 (81%)
11–30	131	40 (31%)	91 (69%)
31–60	95	33 (35%)	62 (65%)
>60	40	18 (45%)	22 (55%)
Total	402	118 (29%)	284 (71%)

Increasing DCIS Grade

DCIS grade	All cases	Invasive cases	Non-invasive cases
Low	31	4 (13%)	27 (87%)
Intermediate	103	26 (25%)	77 (75%)
High	239	86 (36%)	153 (64%)
Unclassified	3	1 (33%)	2 (67%)
Unknown	26	1 (4%)	25 (96%)
Total	402	118 (29%)	284 (71%)

Allows risk of invasion to be objectively estimated pre-operatively, and therefore an informed decision made about whether SLNB should be performed at the same time as definitive surgery