Fig 1.
CONSORT flow chart.
Fig 2.
An abnormality detected via screening mammography in a 47-year-old woman.
(A) Left craniocaudal magnification and compression views reveal regional amorphous microcalcifications that correlate with the ultrasound (US)-detected lesion (mammography skin marking). (B) US shows microcalcification in a heterogeneously hypoechoic area (arrows). (C) Specimen mammography indicates a large amount of microcalcification. (D) Photomicrography of 13-gauge vacuum-assisted biopsy (VAB; original magnification, ×40; hematoxylin and eosin [H&E] stain) reveals a ductal carcinoma in situ (DCIS) with involvement in multiple ductal spaces. (E) After total mastectomy, the final diagnosis was upgraded to invasive ductal carcinoma with a 0.3-cm invasive focus (arrows) and 7.7-cm area of DCIS (original magnification, ×40; [H&E] stain).
Fig 3.
An abnormality detected during screening mammography in a 69-year-old asymptomatic woman.
(A) Left craniocaudal magnification and compression views show segmental pleomorphic microcalcifications that correlate with the ultrasound (US)-detected lesion (mammography skin marking). (B) US shows ductal dilatation with internal microcalcification (arrows). (C) Photomicrography of a 13-gauge vacuum-assisted biopsy (original magnification, ×40; hematoxylin and eosin [H&E] stain) shows tumor cell infiltration into the stroma; this case was confirmed as an invasive ductal carcinoma (arrows). (D) Only ductal carcinoma in situ (DCIS; 5.6-cm extent) remained in the mastectomy specimen. Photomicrography (original magnification, ×40; H&E stain) shows a post-biopsy scar area (arrows) in the DCIS background.
Fig 4.
Invasive ductal carcinoma in the upper inner quadrant of the right breast of a 39-year-old woman.
(A, B) Axial (A) and reformatted sagittal (B) T1-weighted magnetic resonance imaging (MRI; T1WI) with early post-gadolinium enhancement show segmental non-mass enhancement in the lower portion of the right breast (arrows). (C) Ultrasound of the non-mass lesion demonstrates a correlation with MRI findings (arrows). This non-mass lesion was confirmed as ductal carcinoma in situ via 13-gauge vacuum-assisted biopsy and surgery.
Fig 5.
A 49-year-old woman with a history of breast-conserving surgery for right breast cancer.
(A) Axial T1WI with early post-gadolinium enhancement shows focal non-mass enhancement in the upper portion of the left breast (arrows). (B) Ultrasound of the NML shows a correlation with MRI findings (arrows). This non-mass lesion was confirmed as a fibrocystic change via 13-gauge VAB. (C) Follow-up MRI showed disappearance of focal non-mass enhancement.
Table 1.
Characteristics of patients and lesions.
Table 2.
Histologic diagnoses.
Table 3.
Underestimation of DCIS.
Table 4.
Underestimation of ADH.
Table 5.
Biopsy time, numbers, and pain scores.