Ductal Carcinoma in Situ of the Breast: MR Imaging Findings with Histopathologic Correlation

Mossa‐Basha, Mahmud; Fundaro, Gina M.; Shah, Biren A.; Ali, Sharif A; Pantelic, Milan

doi:10.1148/rg.306105510

Cited by 48 publications

(28 citation statements)

References 37 publications

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“…In our sample population MRI overestimated the pathology size in 24% of the cases, which is consistent with the literature, ranging from 6% to 81% [2,10]. However, it should be remembered that for TNM classification, pathologists consider just the invasive component size of the tumor, while it is well established that MRI measurement includes both invasive and noninvasive components [5,11,12].…”

Section: Discussionsupporting

confidence: 89%

Tumor size assessment of invasive breast cancers: which pathological features affect MRI-pathology agreement?

et al. 2018

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Background: Preoperative assessment of tumor size is important in breast cancer treatment planning, especially in breast conservation surgeries. The use of the Magnetic Resonance Imaging (MRI) is increasing among patients with newly diagnosed breast cancers. However, some pathological features can overestimate the measurement of tumor size by MRI, increasing mastectomy rates. The objective is to evaluate which pathological features may affect the agreement between MRI and pathologic tumor size on invasive breast carcinomas. Methods: Eighty seven patients with breast cancer who underwent preoperative breast MRI were retrospectively evaluated. The main tumor size measured by MRI was compared with pathology (gold standard) and concordance was defined as a greater diameter difference of less than 10 mm. Results: There was MRI-pathology concordance in 60 cases (69.0%), MRI overestimated tumor size in 21 (24.1%) and underestimated in 6 (6.9%). After multivariate analysis, only associated ductal carcinoma in situ (DCIS) remained significantly related to overestimation of tumor size on MRI (OR: 9.00; 95% IC:1.13-71.87; p = 0.038). Conclusion: There was good correlation between tumor size evaluation on MRI and pathology. The presence of associated DCIS was the only pathological parameter associated with size overestimation on MRI.

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Section: Discussionsupporting

confidence: 89%

Tumor size assessment of invasive breast cancers: which pathological features affect MRI-pathology agreement?

et al. 2018

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“…Two patients had linear enhancement patterns. Segmental or linear enhancements have been reported as features of ductal carcinoma in situ on MRI (16). …”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Features of Idiopathic Granulomatous Mastitis: A Retrospective Analysis

et al. 2016

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BackgroundGranulomatous mastitis is a rare and benign inflammatory breast disease that may clinically and radiologically mimic breast cancer.ObjectivesThe aim of this study was to evaluate the features of idiopathic granulomatous mastitis (IGM) on breast magnetic resonance imaging (MRI) with mammographic and sonographic findings.Patients and MethodsA retrospective analysis was conducted on 20 patients with IGM who had been diagnosed by needle core or excisional biopsy at a single institution between 2006 and 2012. All of the patients underwent MRI for suspicious breast findings prior to biopsy. MRI examinations were performed on a 1.5 T scanner. The MRI findings were evaluated in accordance with the breast imaging-reporting and data system (BI-RADS) MRI lexicon established by the American College of Radiology.ResultsMRI detected a total of 29 lesions in the 20 patients. Fourteen of these lesions were seen as mass enhancements, with the remaining 15 identified as non-mass enhancements (NMEs). The median size of all lesions was 3.6 cm (range, 0.7 - 6.7 cm). The most frequently observed features were masses with a round shape (9 out of 14, 64%), smooth contour (11 out of 14, 78%), and a rim enhancement pattern (10 out of 14, 71%). The most common features of the 15 NME lesions were segmental distribution (6 out of 15, 40%) and heterogeneous enhancement patterns (8 out of 15, 53%). The time-intensity curves of the dynamic studies showed benign type one signal intensity (persistent enhancement pattern) in the majority of lesions (10 out of 20, 50%).ConclusionOur study suggests that breast MRI findings of IGM have a wide spectrum. Rim enhancement patterns are frequently seen on contrast enhanced images, but the imaging findings are nonspecific and cannot be used definitively to distinguish between benign and malignant lesions.

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“…At pathologic analysis, DCIS shows proliferation of malignant epithelial cells that line a terminal ductal-lobular unit without invasion through the basement membrane (1)(2)(3). DCIS accounts for over 20% of newly diagnosed cases of breast cancer in the United States (4,5) and is rising in incidence, increasing from 5.8 to 32.5 cases per 100,000 women between 1975 and 2004 (5).…”

Section: Introductionmentioning

confidence: 99%

Ductal Carcinoma in Situ of the Breasts: Review of MR Imaging Features

Greenwood¹,

Heller²,

Kim³

et al. 2013

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The incidence of ductal carcinoma in situ (DCIS) has increased over the past few decades and now accounts for over 20% of newly diagnosed cases of breast cancer. Although the detection of DCIS has increased with the advent of widespread mammography screening, it is essential to have a more accurate assessment of the extent of DCIS for successful breast conservation therapy. Recent studies evaluating the detection of DCIS with magnetic resonance (MR) imaging have used high spatial resolution techniques and have increasingly been performed to screen a high-risk population as well as to evaluate the extent of disease. This work has shown that MR imaging is the most sensitive modality currently available for identifying DCIS and is more accurate than mammography in evaluating the extent of DCIS. MR imaging is particularly sensitive for identifying high-grade and intermediate-grade DCIS. DCIS may have variable morphologic features on MR images, with non-mass enhancement morphology being the most common manifestation. Less commonly, DCIS may also manifest as a mass on MR images, in which case it is most likely to be irregular. The kinetics of DCIS are also variable, with fast uptake and a plateau curve reported as the most common kinetic pattern. Additional MR imaging tools such as diffusion-weighted imaging and quantitative kinetic analysis combined with the benefit of high field strength, such as 3 T, may increase the sensitivity and specificity of breast MR imaging in the detection of DCIS.

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Ductal Carcinoma in Situ of the Breast: MR Imaging Findings with Histopathologic Correlation

Cited by 48 publications

References 37 publications

Tumor size assessment of invasive breast cancers: which pathological features affect MRI-pathology agreement?

Tumor size assessment of invasive breast cancers: which pathological features affect MRI-pathology agreement?

Magnetic Resonance Imaging Features of Idiopathic Granulomatous Mastitis: A Retrospective Analysis

Ductal Carcinoma in Situ of the Breasts: Review of MR Imaging Features

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