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What is Which of the following is the most sensitive investigation for DCIS (Ductal carcinoma in-situ) of breast? and explain in detail?
The most sensitive test for the diagnosis of DCIS is mammography. Calcifications without an associated mass are not routinely visible on ultra sound. So in majority of cases the diagnostic procedure is a stereotactic core needle biopsy (SCNB) using mammographic localization. Screening with MRI is superior in younger women as the sensitivity of mammogram is decreased due to the dense breast parenchyma. Mammography has a sensitivity of 90% and specificity of 94%. The commonest mammographic abnormality of DCIS is microcalcification other features include asymmetric density and mass. High grade DCIS is associated with linear and branching calcification whereas low grade DCIS is associated with fine and granular calcification. Invasive cancer appear as a speculated mass. Since the onset of mammographic screening. Ductal carcinoma in situ detection has markedly increased from 5% to 30% of all cancers detected. Ref: Magnetic Resonance Tomography By Maximilian F. Reiser, Page 701; Management of Breast Diseases By Manfred Kaufman, Pages 206-207