This focal Ductal Carcinoma is easily seen.
The red arrows indicate the microcalcifications.
Note how readily visible these are on the adjacent mammogram confirming the importance of the complimentary modalities.
DCIS is by far more common than LCIS, and more importantly, it should be distinguished as a clearly malignant lesion. Ductal epithelial cells undergo malignant transformation and proliferate intraluminally. Eventually, the cells outstrip their blood supply and become necrotic centrally. This debris can calcify and be detected mammographically. Moreover, the lesions also may be palpable clinically. Five pathologic subtypes have been identified: comedo, papillary, micropapillary, solid, and cribriform. Most lesions represent a combination of at least two of these subtypes. The presence of comedo necrosis is an independent risk factor for subsequent ipsilateral breast cancer (NSABP-B17).
The procedure is usually performed under ultrasound control by a radiologist. The injection of blood contains small cells called platelets, which contain platelet derived growth factor. This substance is thought to promote tendon healing. A variation on the technique is Platelet Rich Plasma(PRP), which is where the whole blood removed from the patient is spun in a centrifuge, separating the cells of the blood. As such a higher concentration of platelets is delivered into the tissue for healing. As yet, there has been no study to demonstrate that a PRP injection is superior to ABI, with both techniques demonstrating improvement in 70-80% of patients.