Figure 3.

Multimodality appearance of pure DCIS presenting as a clinically palpable mass in a 39-year-old woman. Craniocaudal (CC) spot-magnification mammographic view of the area of palpable concern in the right breast at 5 o’clock (A) demonstrates an oval-shaped mass with circumscribed margins and fine pleomorphic calcifications within the mass (arrow). A transversely oriented ultrasound image (B) demonstrates an oval-shaped complex solid and cystic mass with circumscribed margins and echogenic foci within consistent with calcifications (arrows). A biopsy was performed under sonographic guidance, and it revealed pure high nuclear grade DCIS. T1-weighted fat-suppressed initial-phase postcontrast MR image from a bilateral breast MRI (C) performed for extent of disease demonstrated the oval-shaped mass at posterior depth at 5 o’clock, with cystic spaces evident on T2-weighted images (D, long arrow) and ductal extension that was sonographically and mammographically occult (short arrow). Pathology remained pure high nuclear grade DCIS on surgical excision.