Breast-conserving Surgery Using Calcification Detection Mode and Contrast Enhanced Ultrasonography in a Patient with Non-palpable Breast Cancer—A Case Report—

Abstract

We report the case of a patient in whom breast-conserving surgery (BCS) was performed for a non-palpable breast cancer (BC) with microcalcifications diagnosed using calcification detection mode (MicroPure^TM) and contrast-enhanced ultrasonography (CEUS). The patient was a 70-year-old woman, in whom mammography showed segmental pleomorphic calcifications in the right breast. The tumor was not palpable, and could not be detected by conventional ultrasonography or enhanced MRI. Vacuum-assisted breast biopsy (VAB) revealed ductal carcinoma in situ (DCIS). The calcifications could be detected using MicroPure^TM with the patient under general anesthesia. Heterogeneous enhancement around these calcifications was detected by CEUS. We performed BCS, after determination of the surgical resection line using MicroPure^TM and CEUS. We could identify the calcifications by intraoperative xeroradiography. The pathological diagnosis of the tumor was apocrine DCIS, 13 mm in diameter. The DCIS was in a small portion of the side margin of the nipple, with no involvement of any other part. We could perform BCS safely and certainly by the use of MicroPure^TM and CEUS, which are reliable for early diagnosis of non-palpable BC with microcalcifications.