Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 2001 Jul;85(2):225–227. doi: 10.1054/bjoc.2001.1877

Growth pattern of ductal carcinoma in situ (DCIS): a retrospective analysis based on mammographic findings

J Z Thomson 1, A J Evans 1, S E Pinder 2, H C Burrell 1, A R M Wilson 1, I O Ellis 2
PMCID: PMC2364049  PMID: 11461081

Abstract

The aim of this study was to obtain information concerning the direction and rates of growth of ductal carcinoma in situ (DCIS). The previous mammograms of 124 women diagnosed with DCIS were examined. If in retrospect calcifications were present on the previous examination, the exact size and position were recorded on both diagnostic and previous imaging. The rates of change and direction of change in extent of calcifications were calculated. 39 women with a diagnosis of DCIS in retrospect had calcifications visible on both their current and prior examinations; these formed the study group. For individual clusters of calcification, change occurred along an axis to the nipple at a mean of 5.5 mm y−1and along an axis at 90° to the nipple at 2.6 mm y−1. Increase in calcifications along the axis to the nipple occurred at 2.6 mm y−1toward and 2.8 mm y−1away from the nipple. Increase in the axis to the nipple occurred at 1.8 mm y−1for low grade, 4.2 mm y−1for intermediate grade and 7.1 mm y−1for high grade. DCIS growth along an axis to the nipple occurs at over twice the rate of growth in the other direction(s) and growth toward and away from the nipple occurred equally. Growth rates increased with increasing nuclear grade of DCIS. These results validate nuclear grading of DCIS. Additionally, the results suggest that increased importance should be placed on identifying the ‘nipple’ and ‘anti-nipple’ margins of DCIS represented by calcifications for both surgical excision and pathological scrutiny. © 2001 Cancer Research Compaign http://www.bjcancer.com

Keywords: breast, mammography, ductal carcinoma in situ, diagnosis

Full Text

The Full Text of this article is available as a PDF (37.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carlson K. L., Helvie M. A., Roubidoux M. A., Kleer C. G., Oberman H. A., Wilson T. E., Pollak E. W., Rochester A. B. Relationship between mammographic screening intervals and size and histology of ductal carcinoma in situ. AJR Am J Roentgenol. 1999 Feb;172(2):313–317. doi: 10.2214/ajr.172.2.9930774. [DOI] [PubMed] [Google Scholar]
  2. Evans A. J., Wilson A. R., Burrell H. C., Ellis I. O., Pinder S. E. Mammographic features of ductal carcinoma in situ (DCIS) present on previous mammography. Clin Radiol. 1999 Oct;54(10):644–646. doi: 10.1016/s0009-9260(99)91083-8. [DOI] [PubMed] [Google Scholar]
  3. Evans W. P., 3rd, Starr A. L., Bennos E. S. Comparison of the relative incidence of impalpable invasive breast carcinoma and ductal carcinoma in situ in cancers detected in patients older and younger than 50 years of age. Radiology. 1997 Aug;204(2):489–491. doi: 10.1148/radiology.204.2.9240541. [DOI] [PubMed] [Google Scholar]
  4. Faverly D. R., Burgers L., Bult P., Holland R. Three dimensional imaging of mammary ductal carcinoma in situ: clinical implications. Semin Diagn Pathol. 1994 Aug;11(3):193–198. [PubMed] [Google Scholar]
  5. Holland R., Hendriks J. H., Vebeek A. L., Mravunac M., Schuurmans Stekhoven J. H. Extent, distribution, and mammographic/histological correlations of breast ductal carcinoma in situ. Lancet. 1990 Mar 3;335(8688):519–522. doi: 10.1016/0140-6736(90)90747-s. [DOI] [PubMed] [Google Scholar]
  6. Lagios M. D., Margolin F. R., Westdahl P. R., Rose M. R. Mammographically detected duct carcinoma in situ. Frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence. Cancer. 1989 Feb 15;63(4):618–624. doi: 10.1002/1097-0142(19890215)63:4<618::aid-cncr2820630403>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  7. Lampejo O. T., Barnes D. M., Smith P., Millis R. R. Evaluation of infiltrating ductal carcinomas with a DCIS component: correlation of the histologic type of the in situ component with grade of the infiltrating component. Semin Diagn Pathol. 1994 Aug;11(3):215–222. [PubMed] [Google Scholar]
  8. Love S. M., Barsky S. H. Breast-duct endoscopy to study stages of cancerous breast disease. Lancet. 1996 Oct 12;348(9033):997–999. doi: 10.1016/S0140-6736(96)04145-1. [DOI] [PubMed] [Google Scholar]
  9. Mai K. T., Yazdi H. M., Burns B. F., Perkins D. G. Pattern of distribution of intraductal and infiltrating ductal carcinoma: a three-dimensional study using serial coronal giant sections of the breast. Hum Pathol. 2000 Apr;31(4):464–474. doi: 10.1053/hp.2000.6536. [DOI] [PubMed] [Google Scholar]
  10. Smart C. R., Myers M. H., Gloeckler L. A. Implications from SEER data on breast cancer management. Cancer. 1978 Mar;41(3):787–789. doi: 10.1002/1097-0142(197803)41:3<787::aid-cncr2820410301>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  11. Tan P. H., Ho J. T., Ng E. H., Chiang G. S., Low S. C., Ng F. C., Bay B. H. Pathologic-radiologic correlations in screen-detected ductal carcinoma in situ of the breast: findings of the Singapore breast screening project. Int J Cancer. 2000 Aug 20;90(4):231–236. doi: 10.1002/1097-0215(20000820)90:4<231::aid-ijc6>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES