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01-09-2010 | Breast Oncology

Is there a Role for MRI in the Preoperative Assessment of Patients with DCIS?

Authors: Lisa R. Allen, MD, Claudia E. Lago-Toro, MD, Jenevieve H. Hughes, MD, Eduardo Careaga, MD, Anjeanette T. Brown, MD, Michael Chernick, MA, PhD, Andrea V. Barrio, MD, Thomas G. Frazier, MD

Published in: Annals of Surgical Oncology | Issue 9/2010

Abstract

Background

Breast magnetic resonance imaging (MRI) is used to identify residual and additional disease in patients with invasive carcinoma. The use of MRI in assessing extent of disease for ductal carcinoma in situ (DCIS) is less well defined. This study assessed the value of MRI in the preoperative evaluation of DCIS.

Materials and Methods

We identified 98 patients with DCIS in 2007. Of these, 63 underwent stereotactic biopsy, followed by MRI. There were 35 who underwent stereotactic biopsy alone. Concordance between MRI and histopathology was defined as the presence or absence of residual disease.

Results

There was no significant difference in mastectomy rates between the MRI and non-MRI group (20.3% vs 25.7%, P = .62). In patients undergoing breast-conserving surgery (BCS), there were fewer positive margins in the MRI versus the non-MRI group (21.2% vs 30.8%, P = .41). Of the 64 cases that underwent preoperative MRI, 43 (67.2%) were concordant. Also, 15 of 43 cases (34.8%) had MRI results that accurately predicted pathologic size. In 28 of 43 patients (65.2%), MRI overestimated disease in 20, by a mean of 1.97 cm. In patients with MRI tumor size >2 cm, MRI overestimated disease by a mean of 3.17 cm. Of the 64 cases, 21 (32.8%) were discordant. Also, 10 of 21 (47.6%) had a positive MRI and no residual disease on histopathology, and 11 of 21 (52.3%) had negative MRI and residual disease on pathology.

Conclusions

MRI does not accurately predict extent of disease in patients with extensive DCIS. In patients with MRI tumor size ≤2 cm, MRI may assist in surgical planning. MRI results in patients with DCIS should be interpreted with caution; decision for mastectomy should not be made on MRI findings alone.

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Title: Is there a Role for MRI in the Preoperative Assessment of Patients with DCIS?
Authors: Lisa R. Allen, MD
Claudia E. Lago-Toro, MD
Jenevieve H. Hughes, MD
Eduardo Careaga, MD
Anjeanette T. Brown, MD
Michael Chernick, MA, PhD
Andrea V. Barrio, MD
Thomas G. Frazier, MD
Publication date: 01-09-2010
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 9/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-010-1000-9

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Springer Medicine

Is there a Role for MRI in the Preoperative Assessment of Patients with DCIS?

Abstract

Background

Materials and Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Materials and Methods

Results

Conclusions

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