The Role of MRI in Evaluation of Ductal Carcinoma in Situ in Female Breast
Noha Abd Al-Kader Ali Mohamed Seif;
Abstract
SUMMARY AND CONCLUSION
D
uctal carcinoma in situ (DCIS) of the breast is a noninvasive carcinoma with a wide spectrum of disease, ranging from low-grade to high-grade malignancy with foci of invasive malignancy. Histologically, DCIS is characterized by a proliferation of malignant cells in the ductal epithelium that are confined to the basement membrane and are not invading the normal breast parenchyma.
The use of Magnetic Resonance Imaging (MRI) for the detection and evaluation of ductal carcinoma in situ continues to increase.
As DCIS is the earliest stage of breast cancer and has the best prognosis, it is likely that further improvements in the detection of breast cancers at a preinvasive stage may improve patient outcomes.
In addition to mammography, screening MR imaging is now becoming part of routine clinical practice for certain patient populations at high risk for breast cancer, especially BRCA1 and BRCA2 mutation carriers.
MRI is thought to be more reliable in the detection of DCIS in women with dense breast tissue, and may be a useful complementary modality in the evaluation of DCIS lesions that appear to have the strong potential to become infiltrative or invasive.
Contrast-enhanced dynamic MRI of the breast is complementary to mammography in the detection of DCIS because enhancement may be seen in areas of calcified as well as noncalcified intraductal carcinoma. This allows detection of noncalcified disease and more accurate assessment of the extent of disease, improving treatment and prognosis.
On MRI, DCIS can manifest in a range of appearances, frequently as clumped nonmasslike enhancement, in a ductal or segmental distribution, most commonly showing rapid initial contrast uptake with plateau, persistent, or washout kinetics in the delayed phase.
Diffusion-weighted MRI (DWI) is an unenhanced MRI sequence that has shown promise for discriminating benign from malignant breast lesions and may yield information different from and complementary to that obtained with DCE-MR.
Pure DCIS lesions have more diffusions restrictions than normal breast tissue and have a lower mean ADC value than normal breast tissue. Low grade lesions exhibit greater DWI signal intensity and DWI CNR than high grade lesions.
MR spectroscopy appears to have a bright future in the field of breast imaging. Its role in differentiating benign from malignant lesions and in improving the specificity of breast MR imaging may result in fewer breast biopsies.
Some means of MR imaging–guided biopsy is essential in a screening program to maximally benefit its sensitivity.
D
uctal carcinoma in situ (DCIS) of the breast is a noninvasive carcinoma with a wide spectrum of disease, ranging from low-grade to high-grade malignancy with foci of invasive malignancy. Histologically, DCIS is characterized by a proliferation of malignant cells in the ductal epithelium that are confined to the basement membrane and are not invading the normal breast parenchyma.
The use of Magnetic Resonance Imaging (MRI) for the detection and evaluation of ductal carcinoma in situ continues to increase.
As DCIS is the earliest stage of breast cancer and has the best prognosis, it is likely that further improvements in the detection of breast cancers at a preinvasive stage may improve patient outcomes.
In addition to mammography, screening MR imaging is now becoming part of routine clinical practice for certain patient populations at high risk for breast cancer, especially BRCA1 and BRCA2 mutation carriers.
MRI is thought to be more reliable in the detection of DCIS in women with dense breast tissue, and may be a useful complementary modality in the evaluation of DCIS lesions that appear to have the strong potential to become infiltrative or invasive.
Contrast-enhanced dynamic MRI of the breast is complementary to mammography in the detection of DCIS because enhancement may be seen in areas of calcified as well as noncalcified intraductal carcinoma. This allows detection of noncalcified disease and more accurate assessment of the extent of disease, improving treatment and prognosis.
On MRI, DCIS can manifest in a range of appearances, frequently as clumped nonmasslike enhancement, in a ductal or segmental distribution, most commonly showing rapid initial contrast uptake with plateau, persistent, or washout kinetics in the delayed phase.
Diffusion-weighted MRI (DWI) is an unenhanced MRI sequence that has shown promise for discriminating benign from malignant breast lesions and may yield information different from and complementary to that obtained with DCE-MR.
Pure DCIS lesions have more diffusions restrictions than normal breast tissue and have a lower mean ADC value than normal breast tissue. Low grade lesions exhibit greater DWI signal intensity and DWI CNR than high grade lesions.
MR spectroscopy appears to have a bright future in the field of breast imaging. Its role in differentiating benign from malignant lesions and in improving the specificity of breast MR imaging may result in fewer breast biopsies.
Some means of MR imaging–guided biopsy is essential in a screening program to maximally benefit its sensitivity.
Other data
| Title | The Role of MRI in Evaluation of Ductal Carcinoma in Situ in Female Breast | Other Titles | دور التصوير بالرنين المغناطيسى فى تقييم سرطان القنوات اللبنية الغير متوغل فى ثدى المرأة | Authors | Noha Abd Al-Kader Ali Mohamed Seif | Issue Date | 2015 |
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