Steven Gordon Thiel MD, Presenter: Nothing to Disclose

Rajshri N. Shah MD, Abstract Co-Author: Nothing to Disclose

Sanaz A. Jansen, Abstract Co-Author: Nothing to Disclose

Hiroyuki Abe MD, Abstract Co-Author: Research grant, Totoku Electric Co, Ltd

Akiko Shimauchi MD, Abstract Co-Author: Nothing to Disclose

Gillian Maclaine Newstead MD, Abstract Co-Author: Research support, Fuji Photo Film Co, Ltd Advisory Board, Konica Minolta Group Advisory Board, Koninklijke Philips Electronics Research support, Bayer AG Speakers Bureau, Bayer AG Spouse, stockholder, Hologic, Inc

We seek to demonstrate that MRI is a valuable tool for evaluating the extent of disease in patients with mammographic calcifications suggestive of DCIS.

Breast MRI examinations performed at the University of Chicago Hospitals from 2002 to 2006 were reviewed. Those performed secondary to suspicious mammographic calcifications suggestive of DCIS were selected. A total of 369 MRI examinations were identified. Initial review involved 100 of these 369 cases, with no chronological preference. The pathology report from biopsy or excision of the suspicious calcifications was also reviewed for each case. Patient identifiers were removed from our database. Mammographic calcifications prompting MRI examination were measured in the craniocaudal and mediolateral projections. Using the transverse and anteroposterior mesurements from the craniocaudal view and the craniocaudal measurement from the mediolateral view, an estimate of the mammographic extent of calcifcation was calculated. The transverse, anteroposterior and craniocaudal extent of abnormal MRI enhancement corresponding to the suspicious mammographic calcifications was also measured.

Of the 100 cases reviewed, 49 cases of suspicious mammographic calcifications were subsequently shown histologically to represent DCIS. The remaining 51 cases were shown histologically to represent either a benign process, a purely invasive carcinoma or lobular carcinoma in situ. Of the 49 cases of DCIS, 35 showed a greater area of abnormal MRI enhancement than was expected based on the area of calcification as measured mammographically. In 14 cases the area of abnormal MRI enhancement was less than expected based on the area of mammographic calcification.

MRI is a valuable diagnostic tool in the evaluation of mammographic calcifications suspicious for DCIS. MRI can improve diagnostic accuracy in predicting extent of disease in such cases and ultimately allows for improved surgical planning.

Breast MRI improves a radiologist's ability to predict the extent of disease in cases of DCIS, thereby improving surgical planning and ultimately patient care.

Thiel, S, Shah, R, Jansen, S, Abe, H, Shimauchi, A, Newstead, G, Evaluating the Extent of Disease with MRI in the Setting of Breast Calcifications Suggestive of DCIS.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5013148.html