MRI of the breast in patients with DCIS to exclude the presence of invasive disease

Deurloo, Eline E.; Sriram, J.D.; Teertstra, Hendrik J.; Loo, Claudette E.; Wesseling, Jelle; Rutgers, Emiel J.; Gilhuijs, Kenneth G. A.

doi:10.1007/s00330-012-2394-5

Cited by 30 publications

(18 citation statements)

References 43 publications

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“…Numerous studies have aimed to identify predictors of invasion once DCIS is diagnosed on preoperative biopsy. Previous studies have suggested the potential of mammographic and MR features [16,24,25] as well as histological features of DCIS [15,16,26] to predict the presence of invasion.…”

Section: Discussionmentioning

confidence: 99%

Intratumoral metabolic heterogeneity predicts invasive components in breast ductal carcinoma in situ

Yoon

Kim

2015

Eur Radiol

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• Preoperative identification of invasion in DCIS is important for axillary nodal management • Higher SUV max and lower AUC-CSH from FDG PET may indicate invasive components of DCIS • Higher TNR and COV from BSGI may indicate invasive components of DCIS • Lower ADC min and higher ADC diff from DWI may indicate invasive components of DCIS • AUC-CSH, an index of metabolic heterogeneity, is an independent predictor for invasive components.

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Section: Discussionmentioning

confidence: 99%

Intratumoral metabolic heterogeneity predicts invasive components in breast ductal carcinoma in situ

Yoon

Kim

2015

Eur Radiol

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“…In the present study, the mean distance between the lesion and nipple was 2.7 mm shorter in the delay phase than the early phase, and prediction of NAC involvement was better when distance was measured in the delay rather than the early phases (Table ). Consistent with this findings, Wang et al reported patients with pure DCIS showed frequently persistent enhancement in the delayed phase (93.3% for DCIS vs 59.3% for invasive disease) and Deurloo et al demonstrated 60% of DCIS patients without invasion showed no enhancement or type I curve of late increasing enhancement. Another potential explanation was the clustered ring enhancement which could be detected in the mainly delayed phase of MRI and in many cases of DCIS presenting non‐mass‐like enhancement.…”

Section: Discussionmentioning

confidence: 54%

Factors predictive of occult nipple‐areolar complex involvement in patients with carcinoma in situ of the breast

Hwang

Park

Koo

et al. 2017

Journal of Surgical Oncology

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“…27 There were 125 with pure DCIS on core biopsy and 18 (14 %) had invasion on final histology. Suspicious enhancement on MRI was seen in 73 lesions, with a type 1 curve was seen in 12, type 2 in 19, and type 3 curve in 42.…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 97%

Getting the right balance in treatment of ductal carcinoma in situ (DCIS)

Fentiman

2013

Int J Cancer Ther Oncol

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As a result of mammographic detection, ductal carcinoma in situ (DCIS) is an increasing problem in breast clinics. Both histopathology and molecular profiling can identify subtypes likely to progress to invasive disease, but there is no subgroup with a zero likelihood of subsequent invasion. In patients with low/intermediate grade DCIS, if breast irradiation is not being carried out after free margins have been achieved the patient should be aware of the risks of withholding and the benefits and morbidity of adjuvant radiotherapy. Either tamoxifen or an aromatase inhibitor may be of value in those with low/intermediate ER+ve disease if radiotherapy is being withheld. For those patients with extensive or multicentric DCIS, mastectomy is the appropriate treatment. This is best combined with sentinel node biopsy and all such cases should be offered immediate reconstruction. IntroductionIn the not so distant past, no real distinction was made between invasive breast cancer and ductal carcinoma in situ (DCIS), both being treated by mastectomy, often including an axillary clearance. Such radical surgery for DCIS became questioned as results emerged from randomised trials indicating that breast conservation was a safe and effective alternative to mastectomy for invasive breast cancer. 1, 2,3,4,5 At the same time, as a by-product of national mammographic screening programmes, the incidence of DCIS was increasing, representing up to a quarter of screen-detected malignancy. In the US in 1975 the incidence of DCIS was 2 per 100,000 and by 1985 was 10, rising to 22 in 1995 and 30 by 2005. 6 Was it reasonable to offer a mastectomy for a non-life threatening condition? We know now that the answer is "yes and no". For some women, as a result of incomplete excision of DCIS, progression to invasive disease will reduce life expectancy. But are we yet in a position to individualise treatment for women diagnosed with DCIS? The aim of treatment is to eradicate the DCIS thereby reducing the risk of recurrence of DCIS or progression to invasive disease. DCIS is a miscellany of conditions with a spectrum of risk of malignancy and it is essential that it is not universally downgraded to being regarded as a benign precursor of with an attendant laissez faire attitude towards the management of high grade disease. HistopathologyRandomised trials of treatment for DCIS have not only yielded evidence of relative efficacy of treatments tested but have also led to central pathological review by pathologists with a special interest in breast cancer. This has enabled the delineation of groups with differing risks of subsequent relapse or progression to invasive disease.Pinder et al conducted a full pathological review of 1222/1694 (72 %) of specimens from women participating in the UKCCCR/ANZ DCIS trial. 7 Those pathological features associated with ipsilateral recurrence in univariate analysis included high cytonuclear grade, larger lesions, growth pattern, presence of necrosis or chronic inflammation, margin involvement or uncertain...

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MRI of the breast in patients with DCIS to exclude the presence of invasive disease

Cited by 30 publications

References 43 publications

Intratumoral metabolic heterogeneity predicts invasive components in breast ductal carcinoma in situ

Intratumoral metabolic heterogeneity predicts invasive components in breast ductal carcinoma in situ

Factors predictive of occult nipple‐areolar complex involvement in patients with carcinoma in situ of the breast

Getting the right balance in treatment of ductal carcinoma in situ (DCIS)

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