The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy

Goto, Mariko; Yuen, Sachiko; Akazawa, Kentaro; Nishida, Kaori; Konishi, Eiichi; Kajihara, Mariko; Shinkura, Nobuhiko; Yamada, Kazuo

doi:10.1007/s00330-011-2357-2

Cited by 35 publications

(47 citation statements)

References 29 publications

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“…When microinvasion or frank invasion ensues, the imaging findings tend to become more typically suspicious 19 . Therefore, masses are more common among invasive neoplasms, especially when portraying spiculated margin, strong initial enhancement followed by washout (Type 3 curve), or other suspicious descriptors, as we have shown in concordance to others 20 . The interest in DWI as a diagnostic and predictive surrogate biomarker for breast malignancy has increased in parallel to improvements in MRI technique [21][22][23] .…”

Section: Discussionsupporting

confidence: 70%

Simple magnetic resonance imaging criteria can differentiate ductal carcinomas in situ from invasive carcinomas

Almeida¹,

Gomes²,

Barros³

et al. 2015

Rev. Bras. Mastol.

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Section: Discussionsupporting

confidence: 70%

Simple magnetic resonance imaging criteria can differentiate ductal carcinomas in situ from invasive carcinomas

Almeida¹,

Gomes²,

Barros³

et al. 2015

Rev. Bras. Mastol.

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“…Our MR imaging examination frequently revealed high signal intensity within DCIS lesions after letrozole treatment. Strong high signal intensity on fat-suppressed T2-weighted imaging is rare in DCIS (Goto et al , 2012), and it may reflect oedematous stroma (Yuen et al , 2007) and/or accumulation of foam cells in DCIS tissues by letrozole treatment.…”

Section: Discussionmentioning

confidence: 99%

Intratumoral concentration of estrogens and clinicopathological changes in ductal carcinoma in situ following aromatase inhibitor letrozole treatment

et al. 2013

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Background:Estrogens have important roles in ductal carcinoma in situ (DCIS) of the breast. However, the significance of presurgical aromatase inhibitor treatment remains unclear. Therefore, we examined intratumoral concentration of estrogens and changes of clinicopathological factors in DCIS after letrozole treatment.Methods:Ten cases of postmenopausal oestrogen receptor (ER)-positive DCIS were examined. They received oral letrozole before the surgery, and the tumour size was evaluated by ultrasonography. Surgical specimens and corresponding biopsy samples were used for immunohistochemistry. Snap-frozen specimens were also available in a subset of cases, and used for hormone assays and microarray analysis.Results:Intratumoral oestrogen levels were significantly lower in DCIS treated with letrozole compared with that in those without the therapy. A great majority of oestrogen-induced genes showed low expression levels in DCIS treated with letrozole by microarray analysis. Moreover, letrozole treatment reduced the greatest dimension of DCIS, and significantly decreased Ki-67 and progesterone receptor immunoreactivity in DCIS tissues.Conclusion:These results suggest that estrogens are mainly produced by aromatase in DCIS tissues, and aromatase inhibitors potently inhibit oestrogen actions in postmenopausal ER-positive DCIS through rapid deprivation of intratumoral estrogens.

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“…If an imaging marker predictive of DCIS upstaging to invasive carcinoma at surgery can be identified using routine imaging, clinicians may be able to better manage patients with underestimated invasive breast cancer. Previous work using radiologist‐identified features has shown that MRI has the potential to diagnose occult invasive disease in DCIS patients . The purpose of this study is to expand upon this previous work by assessing the ability of semiautomatically assessed MRI features to predict DCIS upstaging to invasive carcinoma at the time of surgery.…”

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confidence: 97%

“…While a CNB is typically sufficient for a pathologist to make a diagnosis of DCIS, the small total volume of tumor sampled by CNB may miss adjacent invasive cancer. At the time of definitive surgery, upstaging to invasive disease occurs in 3.5–56% of cases . A meta‐analysis of DCIS upstaging rates by Brennan et al concluded an average upstaging rate of 25.9%, while Lee et al reviewed the literature to find an average rate of 20.9%.…”

mentioning

confidence: 99%

Can algorithmically assessed MRI features predict which patients with a preoperative diagnosis of ductal carcinoma in situ are upstaged to invasive breast cancer?

Harowicz

Saha

Grimm

et al. 2017

Magnetic Resonance Imaging

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Purpose To assess the ability of algorithmically assessed magnetic resonance imaging (MRI) features to predict the likelihood of upstaging to invasive cancer in newly diagnosed ductal carcinoma in situ (DCIS). Materials and Methods We identified 131 patients at our institution from 2000–2014 with a core needle biopsy-confirmed diagnosis of pure DCIS, a 1.5 or 3T preoperative bilateral breast MRI with nonfat-saturated T1-weighted MRI sequences, no preoperative therapy before breast MRI, and no prior history of breast cancer. A fellowship-trained radiologist identified the lesion on each breast MRI using a bounding box. Twenty-nine imaging features were then computed automatically using computer algorithms based on the radiologist’s annotation. Results The rate of upstaging of DCIS to invasive cancer in our study was 26.7% (35/131). Out of all imaging variables tested, the information measure of correlation 1, which quantifies spatial dependency in neighboring voxels of the tumor, showed the highest predictive value of upstaging with an area under the curve (AUC) = 0.719 (95% confidence interval [Cl]: 0.609–0.829). This feature was statistically significant after adjusting for tumor size (P < 0.001). Conclusion Automatically assessed MRI features may have a role in triaging which patients with a preoperative diagnosis of DCIS are at highest risk for occult invasive disease. Level of Evidence 4

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The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy

Cited by 35 publications

References 29 publications

Simple magnetic resonance imaging criteria can differentiate ductal carcinomas in situ from invasive carcinomas

Simple magnetic resonance imaging criteria can differentiate ductal carcinomas in situ from invasive carcinomas

Intratumoral concentration of estrogens and clinicopathological changes in ductal carcinoma in situ following aromatase inhibitor letrozole treatment

Can algorithmically assessed MRI features predict which patients with a preoperative diagnosis of ductal carcinoma in situ are upstaged to invasive breast cancer?

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