Document Detail


Is there a role for MRI in the preoperative assessment of patients with DCIS?
MedLine Citation:
PMID:  20217259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 < or = 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.
Authors:
Lisa R Allen; Claudia E Lago-Toro; Jenevieve H Hughes; Eduardo Careaga; Anjeanette T Brown; Michael Chernick; Andrea V Barrio; Thomas G Frazier
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Publication Detail:
Type:  Journal Article     Date:  2010-03-09
Journal Detail:
Title:  Annals of surgical oncology     Volume:  17     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2395-400     Citation Subset:  IM    
Affiliation:
Department of Surgery, Drexel University College of Medicine, Philadelphia, PA, USA. lisa.weisfelner@drexelmed.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Breast Neoplasms / diagnosis*,  surgery
Carcinoma, Intraductal, Noninfiltrating / diagnosis*,  surgery
Female
Humans
Magnetic Resonance Imaging / methods*
Mammography
Mastectomy
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Neoplasm, Residual / diagnosis*,  surgery
Preoperative Care
Prognosis
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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