Preoperative Breast MRI for Newly Diagnosed Ductal Carcinoma in Situ: Imaging Features and Performance in a Multicenter Setting (ECOG-ACRIN E4112 Trial)

Chou, Shinn-Huey S.; Romanoff, Justin; Lehman, Constance D.; Khan, Seema A.; Carlos, Ruth C.; Badve, Sunil; Xiao, Jennifer; Corsetti, Ralph L.; Javid, Sara H.; Spell, Derrick W.; Han, Linda; Sabol, Jennifer L.; Bumberry, John R; Gareen, Ilana F.; Snyder, Bradley S.; Gatsonis, Constantine; Wagner, Lynne I.; Wolff, Antonio C.; Miller, Kathy D.; Sparano, Joseph A.; Comstock, Christopher; Rahbar, Habib

doi:10.1148/radiol.2021219016

Cited by 4 publications

(7 citation statements)

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“…11 Chou et al evaluated qualitative MRI features of DCIS and found that most DCIS were identified as NME (58%) on MRI, with the NME having a larger median size than the size quantified on mammogram. 18 In our study, the correlation coefficient between NME and DCIS was .63, which was much stronger than the correlation between NME and invasive cancer. Gweon et al reported that 24.5% of IDC associated with a mass component was accompanied by NME on preoperative MRI, and HER2 positivity was significantly associated with malignant pathologic results from NME.…”

Section: Discussioncontrasting

confidence: 55%

How Well Does Non-mass Enhancement Correlate With DCIS/Invasive Cancer?

Huang

Dufresne

Baksh

et al. 2023

The American Surgeon™

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Introduction Contiguous non-mass enhancement (NME) often coexists with a solid tumor component on MRI, but it can be challenging to predict whether NME represents invasive breast cancer, ductal carcinoma in situ (DCIS), benign disease, or biopsy site reaction. The purpose of this study was to determine the association between the size/extent of NME and the presence of invasive cancer and/or DCIS on final pathology. Methods This was a single institution retrospective analysis of a prospectively maintained breast cancer registry (2010-2020). Female patients who underwent surgical resection were included if they had a diagnosis of invasive breast cancer (with or without DCIS) and had an MRI showing both a solid mass and contiguous NME. The size of NME on MRI was compared with the size of invasive cancer and/or DCIS on the final pathology. Results From a total of 3443 patients, 225 patients were included. 86.2% had invasive ductal carcinoma (IDC), and 12.0% had invasive lobular carcinoma 76.9% were ER+, 16.4% were HER2+, and 13.3% were triple negative breast cancer (TNBC). 18.7% received neoadjuvant chemotherapy (NCT) of whom 31% achieved a complete radiographic/pathologic response. Pearson correlation coefficients (r) between the size of NME and invasive cancer/DCIS showed a strong and positive correlation of MRI NME with DCIS on pathology in patients without NCT. Subgroup analysis showed the strongest correlations for NME and DCIS among non-white (r = .70) and HER2 + patients (r = .74) who did not receive NCT. Conclusions Strong correlations between NME and DCIS were found for HER2 + disease and non-white patients, but only modest correlations were found for other patient/disease characteristics. These correlations may impact decisions in surgical approach.

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Section: Discussioncontrasting

confidence: 55%

How Well Does Non-mass Enhancement Correlate With DCIS/Invasive Cancer?

Huang

Dufresne

Baksh

et al. 2023

The American Surgeon™

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“…In the prospective observational study carried out by the University of Bonn, Germany, almost half of the grade 3 DCIS were missed by mammography and spotted by MRI alone [123]. Additional neoplastic foci either in the ipsilateral or contralateral breast were found in up to 6.2% of the cases [126]. In the study conducted at the MD Anderson [126], 3.9% of patients developed invasive BC shortly after the treatment of DCIS, leaving open the question of whether they were new primary tumours or residual DCIS that progressed to invasive tumours.…”

Section: Decision Support Tools: Imaging Biomarkersmentioning

confidence: 99%

“…Additional neoplastic foci either in the ipsilateral or contralateral breast were found in up to 6.2% of the cases [126]. In the study conducted at the MD Anderson [126], 3.9% of patients developed invasive BC shortly after the treatment of DCIS, leaving open the question of whether they were new primary tumours or residual DCIS that progressed to invasive tumours. As previously said, MRI shows a great accuracy in identification of tumour extension which is generally seen to be larger than that in mammography [126], raising the question about the risk of overestimation [127].…”

Section: Decision Support Tools: Imaging Biomarkersmentioning

confidence: 99%

“…In the study conducted at the MD Anderson [126], 3.9% of patients developed invasive BC shortly after the treatment of DCIS, leaving open the question of whether they were new primary tumours or residual DCIS that progressed to invasive tumours. As previously said, MRI shows a great accuracy in identification of tumour extension which is generally seen to be larger than that in mammography [126], raising the question about the risk of overestimation [127]. The literature is not consistent in demonstrating that the use of MRI increases the rate of mastectomy, diminishes the probability of close/positive margins leading to fewer re-excisions in BC [128,129], and reduces LRs.…”

Section: Decision Support Tools: Imaging Biomarkersmentioning

confidence: 99%

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Tools to Guide Radiation Oncologists in the Management of DCIS

Leonardi,

Zerella,

Lazzeroni

et al. 2024

Healthcare

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Similar to invasive breast cancer, ductal carcinoma in situ is also going through a phase of changes not only from a technical but also a conceptual standpoint. From prescribing radiotherapy to everyone to personalized approaches, including radiotherapy omission, there is still a lack of a comprehensive framework to guide radiation oncologists in decision making. Many pieces of the puzzle are finding their place as high-quality data mature and are disseminated, but very often, the interpretation of risk factors and the perception of risk remain very highly subjective. Sharing the therapeutic choice with patients requires effective communication for an understanding of risks and benefits, facilitating an informed decision that does not increase anxiety and concerns about prognosis. The purpose of this narrative review is to summarize the current state of knowledge to highlight the tools available to radiation oncologists for managing DCIS, with an outlook on future developments.

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“…A microcalcificaciones, y también para identificar el cáncer infiltrante oculto mediante la detección de esta neoplasia cuando hay mayor realce en la zona de las microcalcificaciones [23][24][25] . La mastografía contrastada tiene una sensibilidad del 85% y una especificidad del 77% 26 ; además demostró un alto rendimiento en la detección del cáncer de mama, especialmente con la interpretación conjunta de imágenes de baja energía y recombinadas 26,27 (Fig.…”

Section: Bunclassified

Manifestaciones radiológicas del carcinoma ductal <i>in situ</i>. ¿Cómo lo diagnosticamos?

Domínguez-García,

Larios-Cruz,

Moguel-Molina

et al. 2023

ARM

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Identificar los hallazgos radiológicos en sus diferentes modalidades de imagen del carcinoma ductal in situ (CDIS) de la mama. Material y métodos: Se hizo una búsqueda de información en PubMed con las palabras "breast" AND "ductal carcinoma in situ", eligiendo artículos de radiología para la obtención de información. Se realizó una búsqueda de imágenes radiológicas y reportes de patología del archivo clínico y radiológico digital del hospital. Resultados: Los hallazgos mastográficos del CDIS son microcalcificaciones en 80% de los casos, de tipo amorfas, pleomorfas, gruesas heterogéneas, finas ramificadas y finas lineales. El hallazgo más común por ultrasonido es el nódulo irregular, hipervascular, hipoecoico y sin sombra acústica posterior. En resonancia magnética y mastografía contrastada el hallazgo más frecuente es el realce no masa. Conclusiones: El CDIS es asintomático; el tamizaje es muy importante en su detección. La morfología, distribución y densidad de las microcalcificaciones sospechosas, motivan al radiólogo a solicitar imágenes adicionales, para categorizar el hallazgo y elegir el mejor método de guía de imagen para la realización de la biopsia.Palabras clave: Microcalcificaciones. BIRADS. Carcinoma ductal in situ (CDIS). Mamografía. HISTOPATOLOGÍALos patrones arquitectónicos son comedón, cribiforme, micropapilar, papilar y sólido 4 . Los CDIS micropapilar, cribiforme y papilar se consideran patrones de bajo grado. Los CDIS con características sólidas o de comedón se consideran patrones de alto grado y tiene más propensión a convertirse en carcinoma infiltrante 4 .El CDIS se clasifica en tres grados nucleares designados como bajo, intermedio o alto. El

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Preoperative Breast MRI for Newly Diagnosed Ductal Carcinoma in Situ: Imaging Features and Performance in a Multicenter Setting (ECOG-ACRIN E4112 Trial)

Cited by 4 publications

References 0 publications

How Well Does Non-mass Enhancement Correlate With DCIS/Invasive Cancer?

How Well Does Non-mass Enhancement Correlate With DCIS/Invasive Cancer?

Tools to Guide Radiation Oncologists in the Management of DCIS

Manifestaciones radiológicas del carcinoma ductal <i>in situ</i>. ¿Cómo lo diagnosticamos?

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