Ductal Carcinoma In-Situ (DCIS) on Breast Imaging

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Ductal Carcinoma In-Situ, or DCIS, may show up on breast imaging in a variety of ways. This includes mammography, ultrasound and breast MRI.

DCIS on Mammography
The most common presentation of DCIS on mammography involves the appearance of calcifications. Several patterns of calcifications are seen with DCIS, including:

  • *Branching calcifications, where the calcifications outline the ducts and appear as branches on a tree
  • *Pleomorphic calcifications, where the calcifications are different shapes and sizes
  • *Crushed stone calcifications, where the calcifications appear pulverized
  • *Widespread calcifications

Below are mammographic images that demonstrate calcifications associated with DCIS: 
 

DCIS Branching Calcifications

Mammogram DCIS Examples

Mammogram 2 view DCIS

Extensive DCIS

 

DCIS may also show up as a nodule or mass on mammography. The following image demonstrates such an example:

DCIS Nodule

DCIS on Ultrasound
DCIS on ultrasound creates many patterns. Nodular DCIS will show a mass on ultrasound. If there are calcifications within the nodular DCIS, one may be able to see these on ultrasound as white flecks. Papillary DCIS, a special variant, will show up as matter within the ducts, like a clog within a pipe. Below are images of DCIS on breast ultrasound. 

DCIS Nodule

DCIS Nodule

3D Ultrasound DCIS

Ultrasound - Papillary CIS

 

DCIS on MRI
DCIS on MRI may create an area of irregular enhancement of the MRI dye into the breast. This appears most commonly as streaking, known as linear enhancement. The dye collection in the breast can also look clumpy or appear in a section of the breast, depending on the involvement of DCIS.

Breast MRI Linear Enhancement

Breast MRI Clumped Enhancement

As with all abnormalities seen on breast imaging, the diagnosis of DCIS requires a sample of tissue or biopsy.