Min Sun Bae, Presenter: Nothing to Disclose

Mi Ri Nae Seo, Abstract Co-Author: Nothing to Disclose

Sun Ah Kim MD, Abstract Co-Author: Nothing to Disclose

Hye Ryoung Koo MD, Abstract Co-Author: Nothing to Disclose

Nariya Cho MD, Abstract Co-Author: Nothing to Disclose

Woo Kyung Moon, Abstract Co-Author: Nothing to Disclose

To determine the prevalence and risk factors of additionally detected breast cancers at MRI in the preoperative evaluation of patients with newly diagnosed ductal carcinoma in situ (DCIS).

A database search was performed for all patients with pure DCIS who had undergone surgery and preoperative MRI. Between February 2004 and December 2011, 312 patients (median 49, range 24 to 82) were diagnosed with DCIS on needle biopsy after dual modality evaluation of mammography and ultrasound (US), and underwent triple modality preoperative evaluation with mammography, US, and MRI. The prevalence of additional MRI-detected cancers was determined and characterized as multifocal (additional cancer within the same quadrant and/or underestimation on mammography and US by more than 2cm than at MRI with pathologic confirmation), multicentric (additional cancer within a separate quadrant), or contralateral cancer. Potential risk factors including age at diagnosis, family history (FH), mammographic density, and tumor size were also examined.

The rate of breast conserving surgery was 63.1% and the re-excision rate was 1.9%. 23 additional foci of cancer were detected at preoperative MRI. Additional MRI-detected cancers were found in 7.4% of the study population (23/312 women). 21 of 23 (91.3%) cancers detected were DCIS, and 2 of 23 (8.7%) were invasive cancer. Of the 23 additional cancers, 20 (86.9%) represented multifocal disease, 1 (4.4%) represented multicentric disease, and 2 (8.7%) represented contralateral breast cancers. Younger age (< 50 years) [p=0.008], high mammographic density (> 50%) [p=0.019], and tumor size > 3cm [p=0.002] were significantly associated with additional sites of cancer detected at MRI. FH was not statistically associated with additional disease [p=0.649].

MRI detected additional sites of cancer which were not evident at mammography and US in 7.4% of patients with newly diagnosed DCIS. Preoperative breast MRI can be considered in younger women with dense breasts and index tumors > 3cm.  

Preoperative breast MRI can detect additional cancers in newly diagnosed DCIS patients, especially with dense breasts and tumors > 3cm. Preoperative breast MRI can be considered in this population.

Bae, M, Seo, M, Kim, S, Koo, H, Cho, N, Moon, W, Breast MRI in the Preoperative Determination of Multifocal, Multicentric, and Contralateral Disease in Patients with Newly Diagnosed Ductal Carcinoma In Situ.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12027358.html