Ductal carcinoma in situ: detection, diagnosis, and characterization with magnetic resonance imaging.

Mouse Cancer Genetics Program, National Cancer Institute, Frederick, MD, USA.
Seminars in Ultrasound CT and MRI (Impact Factor: 1.29). 08/2011; 32(4):306-18. DOI: 10.1053/j.sult.2011.02.007
Source: PubMed

ABSTRACT Ductal carcinoma in situ (DCIS) is a preinvasive malignancy that currently accounts for over 20% of newly diagnosed breast cancers in the US. This article reviews how clinical magnetic resonance imaging methods are being implemented for the detection, diagnosis and characterization of DCIS. Research strategies that are being pursued to help realize the full potential for magnetic resonance imaging to improve the outcomes of patients diagnosed with DCIS are discussed.

1 Bookmark
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: To evaluate the menstrual cycle and breast composition influence on background parenchymal enhancement of breast magnetic resonance imaging (MRI) and to investigate the optimal time for breast MR examinations. MATERIALS AND METHODS: We evaluated the dynamic contrast-enhanced breast MR images of 238 women who had completed a questionnaire survey about menstrual status. On MRI, the degree of enhancement (DE) of normal parenchyma was measured in the images 2 minutes and 6 minutes after contrast injection. A comparison between premenopausal and postmenopausal women and a separate comparison between dense breasts and fatty breasts were analyzed according to the premenopausal women's menstrual cycle. RESULTS: Premenopausal women showed significantly higher DE than the postmenopausal women (P < 0.001). In premenopausal women, overall DE of fatty breasts and dense breasts was not different. However, fatty breasts showed the highest DE in the 4th week and lowest DE in the 2nd week, while dense breasts showed the highest DE in the 3rd week and the lowest DE in the 4th week of menstrual cycle. CONCLUSION: The influence of menstrual cycle on the enhancement of breast parenchyma is different according to the breast composition. The optimal time for breast MRI could be different for dense and fatty breasts. J. Magn. Reson. Imaging 2013. © 2013 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 04/2013; · 2.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Breast magnetic resonance (MR) imaging is increasingly performed for a variety of indications, most commonly with the goal of detecting breast cancer. Percutaneous biopsy (usually under MR guidance or ultrasound if there is a correlating finding) is commonly used to evaluate suspicious imaging findings detected on MR imaging with the goal of identifying malignancy. It is important to be familiar with the characteristics and management of high-risk lesions detected or biopsied under MR guidance. This review focuses on the appearance of a variety of breast lesions detected on MR imaging that require excision with focus on pathologic correlation.
    Magnetic resonance imaging clinics of North America 08/2013; 21(3):583-99.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To identify preoperative features that could be used to predict invasive breast cancer in women with a diagnosis of ductal carcinoma in situ (DCIS) at ultrasound (US)-guided 14-gauge core needle biopsy (CNB). Methods A total of 86 DCIS lesions that were diagnosed at US-guided 14-gauge CNB and excised surgically in 84 women were assessed. We retrospectively reviewed the patients’ medical records, mammography, US, and MR imaging. We compared underestimation rates of DCIS for the collected clinical and radiologic variables and determined the preoperative predictive factors for upstaging to invasive cancer. Results Twenty-seven (31.4%) of 86 DCIS lesions were upgraded to invasive cancer. Preoperative features that showed a significantly higher underestimation of DCIS were palpability or nipple discharge (p = 0.040), number of core specimens less than 5 (p = 0.011), mammographic maximum lesion size of 25 mm or larger (p = 0.022), mammographic mass size of 40 mm or larger (p = 0.046), sonographic mass size of 32 mm or larger (p = 0.009), lesion size of 30 mm on MR (p = 0.004), lower signal intensity (SI) on fat-saturated T2-weighted MR images (FS-T2WI) (p = 0.005), heterogeneous or rim enhancement on MR images (p = 0.009), and apparent diffusion coefficient (ADC) values lower than 1.04 × 10−3 mm2/s on diffusion-weighted MR imaging (DWI) (p < 0.001). Conclusion Clinical symptom of palpability or nipple discharge, number of core specimen, mammographic maximum lesion or mass size, SI on FS-T2WI, heterogeneous or rim enhancement on MR, and ADC value may be helpful in predicting the upgrade to invasive breast cancer for DCIS diagnosed at US-guided 14-gauge CNB.
    European journal of radiology 01/2014; · 2.65 Impact Factor