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Aug 25, 2017 11:59PM
The short answer is yes. see this page
Excerpt: "It should be noted that not all cases of ductal carcinoma in situ will show microcalcifications. In these situations, high resolution ultrasound can be useful for detecting non-calcified DCIS. However, there would typically have to be some compelling reason to use ultrasound, such as a high risk patient or unusual clinical features. Approximately 10-20% of DCIS cases will not show calcifications at all and about 16% of all breast DCIS is hidden from mammography altogether."
The long answer is DCIS is not cancer yet. It is the last step in the spectrum of breast disease just before invasive carcinoma. It does not metastasize, it is not found in lymph nodes, but it is usually treated with lumpectomy +/- Tamoxifen +/- radiation. This may change in the future.
There are three grades, I,II, and III, the first two are considered "low grade" and the third "high grade". DCIS can progress to invasive cancer in some patients or remain quiescent in others. Of all patients with DCIS no one knows or can tell who will go on to invasive disease so today everyone gets treated. You may have heard the terms "over diagnosis" or "over treatment"? These terms refer to DCIS, especially low grade.
Here is an excerpt from an article at Cancer.Org explaining why it might not be a life threatening situation if DCIS cannot be seen on mammography:
"In ductal carcinoma in situ (DCIS), the abnormal cells are just in the top layers of cells in the ducts within the breast and haven't invaded any deeper. In some women, DCIS turns into invasive breast cancer, or sometimes an area of DCIS contains invasive cancer. In some women, though, the cells just stay within the ducts and never invade deeper or spread to lymph nodes or other organs. The uncertainty about how DCIS will behave can make it hard to choose the best treatments. Researchers are looking for ways to help with these challenges.
Researchers are studying the use of computers and statistical methods to estimate the odds that a woman's DCIS will become invasive. Decision aids are another approach. They ask a woman with DCIS questions that help her decide which factors (such as survival, preventing recurrence, and side effects) she considers most important in choosing a treatment.
Another recent area of research and debate among breast cancer specialists is whether changing the name of DCIS to one that emphasizes that this is not an invasive cancer could help some women avoid overly aggressive treatment."
Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com