uhrad.com - Women's Diagnostic Imaging Teaching Files

Case Five - Multifocal Ductal Carcinoma of the Breast

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Clinical History: 60-year-old asymptomatic female for screening mammogram.

Findings:Cluster of pathologic calcifications with minimal change over time.

9/22/92
Cluster of multiple indeterminate calcifications in mid portion of left breast.

6/3/94
Cluster of heterogenous multiple calcifications, slightly better defined than 9/25/92.

6/28/95
Calcifications now pleomorphic and increased in number since 6/3/94. Worrisome for carcinoma.

7/05/95
Pleomorphic calcifications, again worrisome.

8/31/95
Needle localization biopsy sample containing calcifications.

Pathology: Multifocal ductal carcinoma in situ, micropapillary and cribriform types - low grade. Focal lobular carcinoma in situ. Fibrocystic disease with atypical ductal epithelial hyperplasia and papillomatosis.

Diagnosis: Multifocal ductal carcinoma in situ.

Discussion: Worrisome calcifications should be biopsied, regardless of stability over time.

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Submitted by:
Anne H. Nicklas, M.D>
Sutek Lie, M.D.