27-year-old, Breast Mass

27-year-old female presented with right upper outer quadrant firm breast mass.

Figure 1. Both breasts CC and MLO views demonstrate widespread distribution of compact microcalcification clusters running from the nipple posteriorly, even over an entire upper outer quadrant of the right breast, accompanied by increased parenchymal density.

Figure 2. Figure 1. Both breasts CC and MLO views demonstrate widespread distribution of compact microcalcification clusters running from the nipple posteriorly, even over an entire upper outer quadrant of the right breast, accompanied by increased parenchymal density.

Figure 3. Ultrasound shows increased parenchymal echogenictiy and expanded lactigerous ducts by soft tissue growth containing echogenic foci of clustered microcalfication.

Figure 4A. Sagittal and coronal precontrast enhanced T2 FS MRI showing segmental area of abnormal high attenuation filling the UOQ.

Figure 4B. Sagittal and coronal precontrast enhanced T2 FS MRI showing segmental area of abnormal high attenuation filling the UOQ.

Figure 5. Homogeneous enhancement and washout kinetics (arrow) encompassing most of the upper outer quadrant.

Diagnosis: DCIS

Sagittal and coronal precontrast enhanced T2 FS MRI shows segmental area of abnormal high attenuation filling the UOQ, showing homogeneous enhancement and washout kinetics (arrows) encompassing most of upper outer quadrant.

Microcalcifications can be an early and only presenting sign of breast cancer.

In large screening programs, DCIS make up to 30% of malignancies diagnosed.

In the context of overdiagnosis, the low grade DCIS cases found on screening mammography are likely to cause a number of cases in which the diagnosis of breast malignancy has been made but could conceivably not have been fatal to the patient.