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1-18 Ex. 1-17 & 18 Subgross and conventional histological images of ducts with extensive necrosis and a few remaining cancer cells. 1 continued The presence of fragmented casting type calcifications is a highly reliable radiological sign of malignancy. Preoperative microscopic diagnosis is necessary for optimum patient management. Histological−mammographic correlation helps us understand that the regions containing calcifications with high, even density and smooth contour will have the fewest viable malignant cells.
The rectangles outline the cluster of calcifications. Ex. 4-3 Fragmented Casting Type Calcifications 33 Differential Diagnostic Problems Ex. 4-4 Specimen radiograph shows that the malignant type calcifications are distributed over a large area (rectangle). 40 mm 35 mm Ex. 4-4 Ex. 4-5 & 6 Histology: 40 mm × 35 mm Grade 3 solid and micropapillary DCIS with signs of epithelial−stromal interaction (periductal desmoplastic reaction and lymphocytic infiltration). Ex. 4-5 Ex. 4 continued Ex. 4-7 Histology: Images of the Grade 3 micropapillary “carcinoma in situ” component with periductal desmoplastic reaction and lymphocytic infiltration.
The main ducts and their branches are distended by innumerable, dotlike calcifications, outlining the duct system. 31 Fig. 32 Image courtesy of Professor Gillian Newstead. 34 Fig. 35 Image courtesy of Professor Peter J. Dempsey. 6 A 40-year-old asymptomatic woman with no family history of breast cancer. First screening examination. (see page 11 for comment) Ex. 6-1 Ex. 6-2 Ex. 6-1 & 2 Right breast MLO and CC projections. There are innumerable calcifications spread throughout the upper half of the breast, but they are restricted to a single lobe.