Abstract
The purpose of this study is to determine if MRI BI-RADS criteria or radiologist perception correlate with presence of invasive cancer after initial core biopsy of ductal carcinoma in situ (DCIS). Retrospective search spanning 2000-2007 identified all core-biopsy diagnoses of pure DCIS that coincided with preoperative MRI. Two radiologists fellowship-trained in breast imaging categorized lesions according to ACR MRI BI-RADS lexicon and estimated likelihood of occult invasion. Semiquantitative signal enhancement ratio (SER) kinetic analysis was also performed. Results were compared with histopathology. 51 consecutive patients with primary core biopsy-proven DCIS and concurrent MRI were identified. Of these, 13 patients (25%) had invasion at excision. Invasion correlated significantly with presence of a mass for both readers (p = 0.012 and 0.001), rapid initial enhancement for Reader 1 (p = 0.001), and washout kinetics for Reader 2 (p = 0.012). Significant correlation between washout and invasion was confirmed by SER (p = 0.006) when threshold percent enhancement was sufficiently high (130%), corresponding to rapidly enhancing portions of the lesion. Radiologist perception of occult invasion was strongly correlated with true presence of invasion. These results provide evidence that certain BI-RADS MRI criteria, as well as radiologist perception, correlate with occult invasion after an initial core biopsy of DCIS.
Original language | English (US) |
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Pages (from-to) | 650-658 |
Number of pages | 9 |
Journal | Breast Journal |
Volume | 19 |
Issue number | 6 |
DOIs | |
State | Published - Nov 2013 |
Externally published | Yes |
Keywords
- breast
- carcinoma
- ductal carcinoma in situ
- invasive ductal carcinoma
- invasive lobular carcinoma
- kinetics
- magnetic resonance imaging
- signal enhancement ratio
ASJC Scopus subject areas
- Internal Medicine
- Surgery
- Oncology