Ductal carcinoma in situ-associated nipple discharge: A clinical marker for locally extensive disease

1998 ◽  
Vol 5 (5) ◽  
pp. 452-455 ◽  
Author(s):  
Ronald L. Bauer ◽  
Kenneth H. Eckhert ◽  
Takuma Nemoto
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Extensive Disease ◽  
Clinical Marker

scholarly journals Galactography with Tomosynthesis Technique (Galactomosynthesis) – Renaissance of a Method?

2018 ◽  
Vol 78 (05) ◽  
pp. 493-498 ◽  
Author(s):  
Rüdiger Schulz-Wendtland ◽  
Caroline Preuss ◽  
Peter Fasching ◽  
Christian Loehberg ◽  
Michael Lux ◽  
...  
Keyword(s):  
High Resolution ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Imaging Technique ◽  
Nipple Discharge ◽  
Full Field ◽  
Contrast Enhanced ◽  
First Time

Abstract Introduction For decades, conventional galactography was the only imaging technique capable of showing the mammary ducts. Today, diagnosis is based on a multimodal concept which combines high-resolution ultrasound with magnetic resonance (MR) mammography and ductoscopy/galactoscopy and has a sensitivity and specificity of up to 95%. This study used tomosynthesis in galactography for the first time and compared the synthetic digital 2D full-field mammograms generated with this technique with the images created using the established method of ductal sonography. Both methods should be able to detect invasive breast cancers and their precursors such as ductal carcinoma in situ (DCIS) as well as being able to identify benign findings. Material and Methods Five patients with pathological nipple discharge were examined using ductal sonography, contrast-enhanced 3D galactography with tomosynthesis and the synthetic digital 2D full-field mammograms generated with the latter method. Evaluation of the images created with the different imaging modalities was done by three investigators with varying levels of experience with complementary breast diagnostics (1, 5 and 15 years), and their evaluations were compared with the histological findings. Results All 3 investigators independently evaluated the images created with ductal sonography, contrast-enhanced 3D galactography with tomosynthesis, and generated synthetic digital 2D full-field mammograms. Their evaluations were compared with the histopathological assessment of the surgical specimens resected from the 5 patients. There was 1 case of invasive breast cancer, 2 cases with ductal carcinoma in situ and 2 cases with benign findings. All 3 investigators made more mistakes when they used the standard imaging technique of ductal sonography to diagnose suspicious lesions than when they used contrast-enhanced galactography with tomosynthesis and the generated synthetic digital 2D full-field mammograms. Conclusion This is the first time breast tomosynthesis was used in galactography (galactomosynthesis) to create digital 3-dimensional images of suspicious findings. When used together with the generated synthetic digital 2D full-field mammograms, it could be a useful complementary procedure for the diagnosis of breast anomalies and could herald a renaissance of this method. Compared with high-resolution ductal ultrasound, the investigators achieved better results with contrast-enhanced galactography using tomosynthesis and the generated synthetic digital 2D full-field mammograms, as confirmed by histopathological findings.

Abstract 634: SOX11 is a potential clinical marker for hormone receptor negative ductal carcinoma in situ

2018 ◽  
Author(s):  
Kazuharu Kai ◽  
Wei Lu ◽  
Fei Yang ◽  
Ximing Tang ◽  
Ignacio I. Wistuba ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Hormone Receptor ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Clinical Marker

scholarly journals Case Report: Ductal CarcinomaIn Situin the Male Breast

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
Joshua Chern ◽  
Lydia Liao ◽  
Raymond Baraldi ◽  
Elizabeth Tinney ◽  
Karen Hendershott ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Early Recognition ◽  
Nipple Discharge ◽  
Contralateral Breast ◽  
Stage Disease ◽  
Male Patients ◽  
Grade 3

High-grade ductal carcinoma in situ is incredibly rare in male patients. The prognosis for ductal carcinoma in situ (DCIS) in a male patient is the same as it would be for a female with the same stage disease; therefore, early recognition and diagnosis are of the utmost importance. We present a case of a male with unilateral invasive ductal carcinoma who was diagnosed with DCIS in the contralateral breast. The DCIS presented as microcalcifications on mammography and was found to be biopsy proven grade 3 papillary DCIS. This case also illustrates the importance of family history and risk factors, all of which need to be evaluated in any male presenting with a breast mass or nipple discharge.

scholarly journals Ductal Carcinoma In situ of the Male Breast

Breast Care ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 288-290 ◽  
Author(s):  
Melissa Brents ◽  
John Hancock
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Histological Grade ◽  
Nipple Discharge ◽  
Left Breast ◽  
Male Breast ◽  
High Grade

Background: Ductal carcinoma in situ of the male breast is an unusual lesion and most often associated with invasive carcinoma. On rare occasions when the in situ component is present in pure form, histological grade is almost always low to intermediate. Imaging for these patients is difficult as gynecomastia is often present and can mask underlying calcifications or carcinoma. Case Report: We report a case of pure high-grade ductal carcinoma in situ of the male breast in a patient with clear nipple discharge. Breast mammography showed bilateral gynecomastia and benign calcifications. Subsequent breast ultrasound showed dilated ducts of the left breast, and a left breast ductogram showed filling defects suggestive of a papilloma. Excisional biopsy and subsequent mastectomy were consistent with high-grade ductal carcinoma in situ. Conclusion: Male breast cancer is uncommon and, although there is increasing awareness, it is less studied compared to female breast cancer. With a clinical history of nipple discharge of any kind, further evaluation with imaging should be considered. In males with gynecomastia, it is important to remember that ductal carcinoma in situ, even of high grade, is difficult to detect on mammography and may not be associated with suspicious calcifications.

scholarly journals DUCTAL CARCINOMA IN SITU OF THE BREAST: A CASE REPORT WITH AN ATYPICAL CLINICAL PRESENTATION

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Joyce Campodonio ◽  
Ana Mayra Oliveira ◽  
Flávio A Machado
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Mammographic Screening ◽  
Axillary Node ◽  
Palpable Mass ◽  
Bloody Nipple Discharge ◽  
The Right

Ductal carcinoma in situ (DCIS) of the breast is a proliferative lesion, precursor of cancer, which has been increasingly diagnosed due to mammographic screening. Tumor size itself does not determine whether the lesion is in situ or invasive, so it is essential to emphasize that DCIS can present with variable extension. We report a case of a 44-year-old female patient that was diagnosed a great (12 cm) DCIS of the breast without microinvasion through pathologic examination. The patient presented with an increase of the right breast, acyclic mastalgia and right bloody nipple discharge. Mammography was inconclusive, the ultrasound suggested inflammation and the incisional biopsy revealed DCIS nuclear grade 3 with compromised lateral margins. It was performed simple mastectomy and axillary node sampling. The clinical presentations of benign and malignant diseases of the breast are variable. The most common symptoms reported by women are pain, palpable mass or nipple discharge. The literature reveals that the extent of this type of cancer is variable, being found in a review intraductal lesions up to 5.4 cm, size smaller than that one that was found in this patient. This finding makes the clinical apresentation interesting to be discussed. Although mammography is the most efficient method to diagnose this injury, clinical breast exam should be performed in all gynecological independent of patient age because it is useful for diagnosing early lesion, considering that it is a palpable lesion.

Microdochectomy for pathologic nipple discharge.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12032-e12032
Author(s):  
Sanjay Zumberlal Baldota ◽  
Lee Min Lai ◽  
S P Raymond ◽  
Simon David Thomson
Keyword(s):  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma In Situ ◽  
Predictive Value ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Breast Disease ◽  
Base Line ◽  
Mammary Duct

e12032 Background: Nipple discharge has a known association with breast cancer, determing which cases to identify as being at high risk is a complex task for the clinician. The current policy at West Herfordshire hospital NHS Trust is to offer microdochectomy to all women who present with unilateral single duct nipple discharge, dominant duct discharge, or peristent duct discharge. The aim of this study was to determine if on basis of the pattern ofnipple discharge, patients could be subselected for microdochectomies, and to create a base line to allow future subselection of patients for survillience only. Methods: All patient with single duct unilateral spontaenous nipple discharge, who underwent microdochectomy, were assessed. Demongraphics, clincial presentation, radilogical assessment, cytology, core biopsy. This group of patients was anlysed and correlated with their final histological assessment. Results: 122 patients were analysed in this study. 7 ( 5.74%) were diagnosed with carcinomas. 4patients had ductal carcinoma in situ, three patients had dutcal carcinoma in situ and invasive ductal carcinoma, of these two patients had blood stained nipple discharge. two other patients had papillary carcinomas, one patient of these two had blood stained nipple discharge. 47 out of 122 patient presened with history of blood statined discharge,30 were negative for cytology, two patients had (ductal carcinoma in situ with Invasive ductal carcinoma and papillary ca) at final histololgy. 17 of the 47 showed cellular cytology.and one patient had intermediate grade DCIS confirmed on final histology, whereas in the remaining sixteen patients histological feaatures of papillomas, duct ectasia, and benign breast disease was noted. Of the 122 patient 42 patients had mammary duct ectasia (34%), 52 patients had papillomas (42%) at final hisotology. Conclusions: The negative predictive value (2/30), appears in this series appreas to be more valuable than, the positive predictive value (1/17) in cellular smears to predict ductal carcinoma or invasive ductal carcinoma. Cytological assessment of nipple discharge is equivocal at its best. Microdochectomy perford for nipple discharge results in a low rate of malignacy on excision and is comparable with other series.

scholarly journals Croatia’s First Experiences in Cytological Diagnosis of High-Grade Ductal Carcinoma in Situ of the Breast: Case Reports and a Review of Literature

2021 ◽  
Vol 6 (6) ◽  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Case Reports ◽  
Nipple Discharge ◽  
Left Breast ◽  
Cytological Diagnosis ◽  
High Grade ◽  
Morphological Criteria

Cases here presented are also first Croatia’s experiences in the cytological diagnosis of breast ductal carcinoma in situ (DCIS). The first patient was a 64-year-old woman, by imaging methods with a wide area of suspect microcalcifications in the left breast lower medial quadrant and abundant, dense, yellow-greyish discharge of the same mammilla and second was a 65-year-old woman with an equivocal lesion in left breast lower lateral quadrant. Morphological findings of both aspirates and nipple discharge from the first patient were practically the same - moderately to highly cellular, with 3D solid aggregates, monolayer sheets and many scattered single clearly malignant cells of large - mainly >5x the diameter of an erythrocyte, round-to-ovaloid, manifestly irregular nuclei, dark blue, polymorphous, often multiple (macro)nucleoli, irregular nuclear outlines and dense, more basophilic, mostly scant cytoplasms arranged in syncytium–like structures. “Dirty” background was overfull of comedo necrosis and dark grayish, sharp, irregular microcalcifications. Cytological diagnosis in both cases was DCIS, high-grade, comedo type. Histopathologically first tumor was big, 6 cm large, estimated as comedo carcinoma with microinvasion focuses not bigger than 1 mm, but without signs of angioinvasion, while the second tumor was smaller, 0.6 cm with wide ducts fully with large polymorphic malignant epithelial cells, central comedo necrosis, cancerisation of some lobules but with the intact basement membrane. It was pure high-grade DCIS, comedo type. Presented cases completely reflect to date knowledge about cytological diagnostic of high-grade DCIS; include necessary morphological criteria - highgrade nuclear atypia, an abundance of comedo necrosis and microcalcifications, confirm our limitation in the presumption of invasion status with large lesion extent, but also prove that cytology is the unquestionably reliable in breast morphological diagnostic, even in such sophisticated and demanding pathological issue like DCIS.

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