Features of occult invasion in biopsy-proven DCIS at breast MRI.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Wisner, DJ; Hwang, ES; Chang, CB; Tso, HH; Joe, BN; Lessing, JN; Lu, Y; Hylton, NM

Published Date

  • 2013

Published In

Volume / Issue

  • 19 / 6

Start / End Page

  • 650 - 658

PubMed ID

  • 24165314

Pubmed Central ID

  • PMC4036640

Electronic International Standard Serial Number (EISSN)

  • 1524-4741

Digital Object Identifier (DOI)

  • 10.1111/tbj.12201


  • eng

Conference Location

  • United States