Ultrasound Image Classification of Ductal Carcinoma In Situ (DCIS) of the Breast: Analysis of 705 DCIS Lesions 1

Watanabe, Takanori; Yamaguchi, Takuhiro; Tsunoda, Hiroko; Kaoku, Setsuko; Tohno, Eriko; Yasuda, Hidemitsu; Ban, Kanako; Hirokaga, Koichi; Tanaka, Kumiko; Umemoto, Takuya; Okuno, Toshitaka; Fujimoto, Yasuhisa; Nakatani, Shuichi; Ito, Jun; Ueno, Ei

doi:10.1016/j.ultrasmedbio.2017.01.008

Cited by 46 publications

(42 citation statements)

References 24 publications

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“…In Japan Association of Breast and Thyroid Sonology (JABTS) BC-02 study, US image classification for DCIS was reported. The most frequent findings were hypo-echoic areas in the mammary gland (48.6%), followed by solid masses (28.0%) and duct abnormalities (10.2%) or mixed masses (8.1%) ( 25 ). Specific findings of US to predict mixed invasive cancer are halo-positive masses and interruption of the interface between the adipose tissue and gland ( 26 ).…”

Section: Standard Treatment For Dcismentioning

confidence: 99%

Current approach and future perspective for ductal carcinoma in situ of the breast

Kanbayashi

Iwata

2017

Japanese Journal of Clinical Oncology

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Section: Standard Treatment For Dcismentioning

confidence: 99%

Current approach and future perspective for ductal carcinoma in situ of the breast

Kanbayashi

Iwata

2017

Japanese Journal of Clinical Oncology

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“…There were 705 DCIS cases collected throughout the BC-02 study, of which 260 cases (36.9%) were masses and 428 cases (60.7%) were non-mass abnormalities. In the remaining 17 cases (2.4%), masses and non-mass abnormalities were coexistent to the same degree and could not be classified as one or the other [2]. Details of the findings were as follows: hypoechoic areas in the mammary gland were found to be the most frequent lesion (48.6%) of DCIS lesions, followed by solid masses (28%) and abnormalities of the ducts (10.2%) or mixed masses (8.1%).…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Fig. 12, when DCIS lesions are present in relatively thick ducts, they can be observed as abnormalities of the ducts, and when these advance into thin ducts and lobules, they may be observed as hypoechoic areas [2].…”

Section: Discussionmentioning

confidence: 96%

“…JABTS classifies breast US findings into masses or non-mass abnormalities in the Japanese guideline third edition published in 2014 [1]. It has been reported that many DCIS cases are evaluated as masses and non-mass abnormalities on US images [2]. Non-mass abnormalities are further classified into five subtypes: abnormalities of the ducts, hypoechoic area in the mammary gland, architectural distortion, clustered microcysts, and echogenic foci without hypoechoic areas.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of ultrasonographic images of ductal carcinoma in situ with abnormalities of the ducts

et al. 2019

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Purpose Although the number of ductal carcinoma in situ (DCIS) cases has increased with the spread of breast cancer screening in Japan, there are very few reports that summarize ultrasound image features of DCIS. The Japan Association of Breast and Thyroid Sonology (JABTS) investigated the incidence of DCIS with masses and non-mass abnormalities and the characteristics of US images in a retrospective, multicenter, observational study (JABTS BC-02 study). The purpose of this report is to clarify the proportion of DCIS with abnormalities of the ducts with each ultrasound finding and the characteristics of US images. Methods The JABTS BC-02 study population was comprised of patients who were examined by ultrasonography, underwent surgery, and were histopathologically diagnosed with DCIS at each study site between January 2008 and December 2012. The US images of DCIS and pathology and clinical information were retrospectively collected from 16 institutions in Japan. The US images were evaluated by 22 experts on the Central Image Interpretation Committee of JABTS. Results Abnormalities of the ducts were noted in 78 (10.5%) of 705 US images of DCIS. Of the 78 cases, the distribution of abnormalities of the ducts was focal or segmental. The second characteristic was the presence of internal echoes in dilated ducts. All cases were accompanied by intraductal solid echoes, and 40 cases (51.3%) were accompanied by echogenic foci. In addition, intraductal solid echoes were continuous or multiple in 72 cases (92.4%), and the shape of the solid echoes was broad-based and/or irregular in 62 cases (79.5%). Conclusion DCIS cases with duct abnormalities on ultrasound were investigated in this study. The important characteristics were as follows: (1) the distribution of ductal dilatation was focal or segmental, (2) solid parts were present in the dilated ducts, (3) the distribution of internal echoes was continuous or multiple, (4) the shape of solid echoes was broad-based and/ or irregular, and (5) internal echoes were sometimes accompanied by echogenic foci. Accurate evaluation of these findings may be useful for diagnosing DCIS. Although the duct abnormalities are included in "ASSOCIATED FEATURES" in ACR BI-RADS ATLAS (USA), we emphasize that this concept is very important for understanding US characteristics of DCIS.

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“…In our experience, ultrasonographic findings in DCIS were mottled/heterogeneous parenchyma with increased vascularity on Doppler, multiple intra cystic solid masses, and peripheral dilated ducts with irregular wall and echogenic contents. Watanabe T et al [15] found that the most frequent ultrasonographic findings in DCIS were hypoechoic areas, followed by solid masses, abnormalities of the ducts or mixed masses, distortion, multiple small cysts, and echogenic foci without a hypoechoic area also were reported. The ultrasound features of DCIS have been described in the literature; however, the classifications vary slightly among authors.…”

Section: Discussionmentioning

confidence: 99%

MRI for assessment of pathologic nipple discharge: is it mandatory?

Zaky

Hafez

Zaky

et al. 2019

Egypt J Radiol Nucl Med

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Background: Benign breast lesions is the most common cause of nipple discharge; however, a rare but major cause is breast cancer. This study assesses the superadded value of MRI in diagnosing causes of pathologic nipple discharge. Ninety-three patients with pathologic nipple discharge were evaluated by sonomammography and DCE-MRI. Sonomammography and MR imaging features were analyzed and correlated with the histopathology. Results: Histopathology revealed 69 benign, three high-risk, and 21 malignant lesions. Simply dilated ducts and presence of a mass on US examination as well as non-mass enhancement and STIR signal changes on MRI were of statistically significant probability in differentiation between benign and malignant causes of pathological nipple discharge (p value = 0.017 and 0.001) and (p value ≤ 0.001). Sensitivity and specificity of mammogram and ultrasound in differentiation between benign and malignant causes of pathologic nipple discharge were 71.4% and 54.2% respectively with positive predictive value of 31.2%,negative predictive value of 86.7%, and accuracy of 58.1%. MRI gave higher sensitivity and specificity of 100% and 83.3% with positive predictive value of 63.6%, negative predictive value of 100%, and accuracy of 87.1%. Conclusion: Magnetic resonance imaging is superior to sonommagraphy in diagnosis of pathologic nipple discharge and we recommend it in special situations.

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Ultrasound Image Classification of Ductal Carcinoma In Situ (DCIS) of the Breast: Analysis of 705 DCIS Lesions 1

Cited by 46 publications

References 24 publications

Current approach and future perspective for ductal carcinoma in situ of the breast

Current approach and future perspective for ductal carcinoma in situ of the breast

Characteristics of ultrasonographic images of ductal carcinoma in situ with abnormalities of the ducts

MRI for assessment of pathologic nipple discharge: is it mandatory?

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