To evaluate the early diagnostic value of ultrasound in ductal carcinoma in situ (DCIS) of breast.

The sonographic characteristics in 261 cases of pathologically-confirmed DCIS from May, 2005 to June, 2015 in Sun Yat-sen University Cancer Center were retrospectively analyzed and the sonograms were divided into mass or ductal change including dilation and extension. The Chi-square test was used to determine the difference of ultrasound diagnostic accuracy between with and without microcalcifications cases.

Two (1.14%) of the 261 lesions were not visible on sonography. The detection rate was 99.23% (259/261) and the diagnostic accuracy was 83.40% (216/259). Sonography revealed a mass in 98 cases (37.84%), ductal changes in 161 cases (62.16%). The diagnostic accuracy of each type was 82.65% (mass), 80.00% (single ductal dilatation), 82.19% (multiple ductal dilatation), 66.67% (mixed echogenicity), 0 (single ductal extension), 87.76% (multiple ductal extension), 100% (mixed type) respectively. Microcalcifications were visible on sonography in 179 (69.11%) of the 259 lesions. The diagnostic accuracies with and without microcalcifications were 93.85% and 67.50%. The diagnostic accuracy in cases with microcalcifications was higher than those without microcalcifications and there was significant difference between these two groups (χ²=14.54, P<0.01).

The diagnostic accuracy of DCIS has close relationship with ultrasound classification and microcalcifications. The accurate interpretation of ultrasound classification is essential for its clinical application and the early diagnosis of DCIS.