A 46-year-old woman presented with a lump in her right breast. Mammography and ultrasound revealed a multi-lobulated mass with ductal extension and clustered microcalcifications in the right breast, along with enlarged lymph nodes. A biopsy was performed and the pathology results confirmed ductal carcinoma of low grade. Ductal carcinoma is the most common type of breast cancer, arising from the ducts of the breast. It is classified based on features like presence of central necrosis and differentiation. Treatment options include mastectomy or lumpectomy with radiation depending on the size and grade of the tumor.

1. Ductal Carcinoma of Breast
Dr. Rohit Basapure (2nd year Resident)
Dr.Yogesh Thube ( 3rd year Resident)
Dr. Hemangini Thakkar (Professor)
Department of Radiology,
Seth Gordhandas Sunderdas Medical College &
KING EDWARD VII MEMORIAL HOSPITAL
MUMBAI, INDIA.

2. Clinical History
• A 46yrs old lady presented with lump in the
right breast.
• There was no pain associated with the lump.
• On clinical examination there was a solid lump
in the upper outer quadrant of the right
breast.
• There was mild puckering of the skin.
• The patient was advised mammography and
ultrasound of breast.

3. Mammography

4. Ultrasound

5. Ultrasound

6. Ultrasound

7. Findings
• On mammography there was a soft tissue shadow seen with
spiculated margin and architectural distortion.
• On a magnified view the mass showed variegated, clustered micro-
calcifications.
• Another similar lesion is seen adjacent to previous lesion which
showed similar architectural distortion with variegated, clustered
micro-calcifications.
• The Ultrasound showed a multi-lobulated structure with post-
acoustic shadowing in right breast at 10 o’clock position, which
confirmed clustered micro-calcifications.
• The mass showed ductal extension.
• Lymph nodes with non preserved hila were noted on ultrasound.
• The skin showed no calcification.
• There was no nipple retraction.
• Rest of the breast tissue appeared normal.

8. Diagnosis
• Differential diagnosis of Ductal Carcinoma was
given.
• Ultrasound guided FNAC was performed.
• The histopathology revealed Ductal Carcinoma
of Low grade.

9. Discussion
• Ductal carcinoma is the breast carcinoma of the ducts.
• Ductal carcinoma is majorly divided into Comedo and non-
comedo types.
• Comedo type is more aggressive while non-comedo type is
less aggressive.
• It is also divided on the basis of presence of central
necrosis.
• Low grade and Intermediate grade which show no central
necrosis and are well differentiated, while high grade shows
central necrosis which is poorly differentiated.
• On mammography and USG clustered microcalcifications
with microlobulations of the lesion are common (50-70%) .
• Treatment modality most commonly includes mastectomy
or lumpectomy (<1-2cm) with irradiation for larger lesions.

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.pdf
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