Which of the following patterns of calcification on mammography is most suspicious for ductal carcinoma in situ (DCIS)?
- A Round calcifications scattered bilaterally
- B Fine linear branching (casting) calcifications in a segmental distribution ✓
- C Eggshell (rim) calcifications in a mass
- D Popcorn-type coarse calcifications
Correct answer: B. Fine linear branching (casting) calcifications in a segmental distribution
Explanation
Fine linear branching or casting calcifications in a ductal (linear or segmental) distribution are highly suspicious for high-grade DCIS. These represent necrotic tumour within dilated ducts with calcification of the necrotic core (comedo necrosis pattern). Round bilateral scattered calcifications are associated with fibrocystic change. Eggshell calcifications are benign (fat necrosis or cyst wall). Popcorn calcifications are pathognomonic of involuting fibroadenoma (benign).
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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