Preoperative identification of multifocality and intraductal extension in breast cancer

Historically, postoperative histopathology has identified the extensive intraductal component (EIC) of infiltrating carcinoma (ICA). Preoperative mammography sometimes revealed calcifications, but planning surgical therapy required preoperative EIC identification. In the authors' study, they have used state-of-the-art mammography (SOFTA) to identify subclinical masses, microcalcifications, and EIC, allowing demarcation of excision area. Of 104 SOFTA-positive cases, 98 showed ICA with EIC. Fifty-two mastectomies were performed: in the 16 that followed SOFTA tumor demarcation of excisional biopsies, no residual carcinoma remained; all 36 mastectomies without SOFTA guidance showed residual carcinoma. Histology confirmed EIC in the remaining 48 cases (excision after SOFTA). For four false-positive studies, surgical results showed ductal prominence related to radial scar of sclerosing adenosis