Current issues in the diagnosis of ductal carcinoma in situ: a radiopathological correlation
Ductal carcinoma in situ (DCIS) falls into a heterogeneous group of tumors, whose diagnosis has increased with the use of mammography as screening method. The Van Nuys Prognostic Index, mainly based on histological nuclear grade and presence of necrosis, is the most reproducible histopathological...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | Spanish |
| Published: |
Universidad de San Martín de Porres
2017-06-01
|
| Series: | Horizonte Médico |
| Subjects: | |
| Online Access: | http://www.medicina.usmp.edu.pe/medicina/horizonte/2017_1/Art9_Vol17_N1.pdf |
| Summary: | Ductal carcinoma in situ (DCIS) falls into a heterogeneous group of tumors, whose diagnosis has increased with the use
of mammography as screening method. The Van Nuys Prognostic Index, mainly based on histological nuclear grade and
presence of necrosis, is the most reproducible histopathological classification system. The most common abnormality
observed during a mammography are microcalcifications, which coexist with other lesions such as masses and architectural
distortion, and represent low-grade lesions. The initial diagnosis should be performed by anamnesis and a detailed physical
examination to help determine the morphostructural characteristics of the lesion. Then an imaging and dynamic approach
should be achieved by magnetic resonance imaging (MRI) complemented by immunohistochemistry to characterize the
tumor. The presence of morphological segmental distribution is typical of malignancy (DCIS). The kinetics of the lesions
using a dynamic MRI varies, with the washout and late enhancement pattern being pathognomonic for DCIS. However,
the dynamic pattern seems to be correlated with mammographic findings. Multidetector CT and MRI findings may be
useful in combination with breast MRI for preoperative mapping. Nevertheless, there are complementary techniques
such as spectroscopy and weighted diffusion that improve the specificity of the MRI and are useful in predicting response
to adjuvant chemotherapy. These future applications will improve the ability for early diagnosis and treatment options |
|---|---|
| ISSN: | 1727-558X 2227-3530 |