Case 8 Clinical history A female of 52 years presented for her first mammographic screen. An area of fine microcalcification was noted in the left upper outer quadrant - indeterminate category. No palpable lesion was identified. Needle core biopsy showed DCIS. Triple approach summary Imaging - Category B Clinical - not relevant Needle core histology - DCIS Management Wide local excision performed, without axillary dissection. Histological appearances - A-C The section shows a florid epithelial proliferative lesion with areas, which taken alone, do not meet the diagnostic criteria for DCIS and other areas which do. Overall, taking into account the size of 20 mm, the appearances are those of low grade ductal carcinoma in situ of predominantly cribriform type. No invasive carcinoma seen. Further management Local excision was complete - margins greater than 10 mm. Post-operative radiation therapy to the breast. No systemic therapy. Clinical follow-up will be maintained. Learning points · The distinction between ADH and DCIS rests, in part, on overall lesion size. · Needle core biopsy is the most appropriate method for the investigation of microcalcifications. · Axillary dissection is contraindicated in DCIS, especially of low grade. |
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| Organisation: FORPATH asbl  |
Coordination: Dr Bernard Van den Heule |
Host: Labo CMP |