Published in:
01-06-2012 | Breast
The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy
Published in: European Radiology | Issue 6/2012
Login to get accessAbstract
Objectives
To evaluate whether magnetic resonance (MR) imaging features can predict the presence of occult invasion in cases of biopsy-proven pure ductal carcinoma in situ (DCIS).
Methods
We retrospectively reviewed 92 biopsy-proven pure DCIS in 92 women who underwent MR imaging. The following MR imaging findings were compared between confirmed DCIS and invasive breast cancer (IBC): lesion size, type, morphological and kinetic assessments by ACR BI-RADS MRI, and findings of fat-suppressed T2-weighted (FS-T2W) imaging.
Results
Sixty-eight of 92 (74%) were non-mass-like enhancements (NMLE) and 24 were mass lesions on MR imaging. Twenty-one of 68 (31%) NMLE and 13 of 24 (54%) mass lesions were confirmed as IBC. In NMLE lesions, large lesions (P = 0.007) and higher signal intensities (SI) on FS-T2W images (P = 0.032) were significantly associated with IBC. Lesion size remained a significant independent predictor of invasion in multivariate analysis (P = 0.032), and combined with FS-T2W SIs showed slightly higher observer performances (area under the curve, AUC, 0.71) than lesion size alone (AUC 0.68). There were no useful findings that enabled the differentiation of mass-type lesions.
Conclusions
Breast MR imaging is potentially useful to predict the presence of occult invasion in biopsy-proven DCIS with NMLE.
Key Points
-
MR mammography permits more precise lesion assessment including ductal carcinoma in situ
-
A correct diagnosis of occult invasion before treatment is important for clinicians
-
This study showed the potential of MR mammography to diagnose occult invasion
-
Treatment and/or aggressive biopsy can be given with greater confidence
-
MR mammography can lead to more appropriate management of patients