Non-mass versus mass-like ultrasound patterns in ductal carcinoma in situ: is there an association with high-risk histology?

Gunawardena, Deepika; Burrows, Sally; Taylor, Donna

doi:10.1016/j.crad.2019.10.009

Cited by 11 publications

(7 citation statements)

References 16 publications

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“…Due to its high sensitivity to soft tissues, US can better show lesions in dense glands and has become the primary imaging method for Chinese women to screen and diagnose breast diseases. For non-mass DCIS, US is difficult to recognize [ 48 ]. Therefore, this retrospective study only examined mass DCIS, which is a limitation of the study.…”

Section: Discussionmentioning

confidence: 99%

Preoperative ultrasound radiomics analysis for expression of multiple molecular biomarkers in mass type of breast ductal carcinoma in situ

Zhao

Lin

et al. 2021

BMC Med Imaging

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Background The molecular biomarkers of breast ductal carcinoma in situ (DCIS) have important guiding significance for individualized precision treatment. This study was intended to explore the significance of radiomics based on ultrasound images to predict the expression of molecular biomarkers of mass type of DCIS. Methods 116 patients with mass type of DCIS were included in this retrospective study. The radiomics features were extracted based on ultrasound images. According to the ratio of 7:3, the data sets of molecular biomarkers were split into training set and test set. The radiomics models were developed to predict the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki67, p16, and p53 by using combination of multiple feature selection and classifiers. The predictive performance of the models were evaluated using the area under the curve (AUC) of the receiver operating curve. Results The investigators extracted 5234 radiomics features from ultrasound images. 12, 23, 41, 51, 31 and 23 features were important for constructing the models. The radiomics scores were significantly (P < 0.05) in each molecular marker expression of mass type of DCIS. The radiomics models showed predictive performance with AUC greater than 0.7 in the training set and test set: ER (0.94 and 0.84), PR (0.90 and 0.78), HER2 (0.94 and 0.74), Ki67 (0.95 and 0.86), p16 (0.96 and 0.78), and p53 (0.95 and 0.74), respectively. Conclusion Ultrasonic-based radiomics analysis provided a noninvasive preoperative method for predicting the expression of molecular markers of mass type of DCIS with good accuracy.

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Section: Discussionmentioning

confidence: 99%

Preoperative ultrasound radiomics analysis for expression of multiple molecular biomarkers in mass type of breast ductal carcinoma in situ

Zhao

Lin

et al. 2021

BMC Med Imaging

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“…In this study, DCIS lesions presented as mass-like lesions or non-mass-like lesions in ultrasonographic images. Previous studies had focused on the non-mass-like lesions of DCIS (11,(19)(20)(21). Uematsu et al (21) defined nonmass-like lesions as an area that had different echogenicity from adjacent breast tissues or the same area in the contralateral breast, accompanied with indistinct margins and undefined shapes, and without space-occupying effect in two different projections.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic features of ductal carcinoma in situ: analysis of 219 lesions

Wang

et al. 2020

Gland Surg

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Background: The purpose of this paper is to clarify the ultrasonographic features and classification of ductal carcinoma in situ (DCIS), and to evaluate the ability of ultrasonography in the prediction of DCIS. Methods: The clinical data, gray-scale ultrasound images and pathological results of 219 DCIS lesions that detected in 203 consecutive patients who underwent ultrasonography and surgery in our hospital from January 1, 2014 to December 31, 2019 were collected retrospectively. Ultrasonographic features and classification of DCIS were summarized, and the accuracy of ultrasonography in predicting different ultrasonographic findings of DCIS were compared. Results: Among the 219 DCIS lesions, 91 (41.6%) presented as mass-like lesions and 128 (58.4%) were non-mass-like lesions. For the 91 mass-like DCIS lesions, 79 were hypoechoic solid masses, 12 were cysticsolid structures. For the 128 non-mass-like DCIS lesions, 114 were hypoechoic areas, 10 were ductal dilatation accompanied with intraductal solid components, and 4 were multiple punctate echogenic foci only. The diagnostic accuracy of ultrasound for the 219 DCIS lesions was 81.7% (179/219). The diagnostic accuracy of mass-like DCIS lesions was 90.1% (82/91), which was significantly higher than that in nonmass-like DCIS lesions [75.8% (97/128), P=0.007]. The diagnostic accuracy of hypoechoic solid masses was significantly higher than those of the other ultrasonographic findings (P=0.002). Ducts abnormalities were detected in 45 (20.5%) lesions and punctate echogenic foci in 134 (61.2%) lesions. The diagnostic accuracy of lesions with ducts abnormalities was 93.3% (42/45), which was significantly higher than that in lesions without ducts abnormalities [78.7% (137/174), P=0.024]. The diagnostic accuracy of lesions with punctate echogenic foci was 92.5% (124/134), which was significantly higher than that in lesions without punctate echogenic foci [64.7% (55/85), P=0.000].Conclusions: DCIS lesions can effectively be recognized as mass-like lesions and non-mass-like lesions by ultrasound. Hypoechoic areas and hypoechoic solid masses were the most common ultrasonographic features of DCIS. Ducts abnormalities and punctate echogenic foci were helpful for the diagnosis of DCIS.

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“…Approximately 25 to 61 % DCIS present as NML on US. [30][31][32] They can be seen as hypoechoic mass or NMLs, calcifications alone, architectural distortion, or ductal change (►Figs. 7 and 8).…”

Section: Malignant Pathologiesmentioning

confidence: 99%

“…Posterior shadowing due to clumped microcalcifications may represent high-grade comedo type DCIS. 32 Pure lobular carcinoma in situ is rare and can be seen as irregular ill-defined hypoechoic masses with occasional calcifications. 33 IDC usually present as irregular hypoechoic masses with posterior shadowing or enhancement, while foci of IDC may be seen along with DCIS presenting as NMLs.…”

Section: Malignant Pathologiesmentioning

confidence: 99%

Approach to Nonmass Lesions on Breast Ultrasound

Mohan,

Dhamija,

Gauba

2024

Indian J Radiol Imaging

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Nonmass lesions in breast ultrasound (US) are areas of altered echogenicity without definite margins or mass effect. However, these lesions may show calcifications, associated architectural distortion, or shadowing just like masses. They vary in their echogenicity, distribution, ductal or nonductal appearance and the associated features that can be seen in variety of benign and malignant pathologies. With no uniform definition or classification system, there is no standardized approach in further risk categorization and management strategies of these lesions. Malignant nonmass lesions are not uncommon and few sonographic features can help in differentiating benign and malignant pathologies. US-guided tissue sampling or lesion localization can be preferred in the nonmass lesions identified on second look US after magnetic resonance imaging or mammography. This article aims to describe various imaging patterns and attempts to provide an algorithmic approach to nonmass findings on breast US.

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Non-mass versus mass-like ultrasound patterns in ductal carcinoma in situ: is there an association with high-risk histology?

Cited by 11 publications

References 16 publications

Preoperative ultrasound radiomics analysis for expression of multiple molecular biomarkers in mass type of breast ductal carcinoma in situ

Preoperative ultrasound radiomics analysis for expression of multiple molecular biomarkers in mass type of breast ductal carcinoma in situ

Ultrasonographic features of ductal carcinoma in situ: analysis of 219 lesions

Approach to Nonmass Lesions on Breast Ultrasound

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