The Role of Preoperative Magnetic Resonance Imaging for Detecting the Extent of Disease and Predicting the Prognosis of Ductal Carcinoma In Situ

Yoo Seung Chung; Youn Soo Lee; Su-Kyung Jeh; Byung-Joo Song; Jeong Soo Kim; Hae Myung Jeon; Sang-Seol Jeong; Woo-Chan Park

doi:10.4048/jbc.2009.12.2.106

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Chung, Lee, Jeh, Song, Kim, Jeon, Jeong, and Park: The Role of Preoperative Magnetic Resonance Imaging for Detecting the Extent of Disease and Predicting the Prognosis of Ductal Carcinoma In Situ

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2009; 12(2): 106-112.

Published online: 30 June 2009

DOI: https://doi.org/10.4048/jbc.2009.12.2.106

The Role of Preoperative Magnetic Resonance Imaging for Detecting the Extent of Disease and Predicting the Prognosis of Ductal Carcinoma In Situ

Yoo Seung Chung, Youn Soo Lee¹, Su-Kyung Jeh², Byung-Joo Song, Jeong Soo Kim, Hae Myung Jeon, Sang-Seol Jeong, Woo-Chan Park

Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

¹Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

²Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

wcpark@catholic.ac.kr

Received 21 November 2008 Accepted 31 March 2009

Abstract

Purpose

Magnetic Resonance Imaging (MRI) is widely used for the preoperative staging of breast cancer. In this study, we investigated a role of preoperative breast MRI for detecting the extent of disease and predicting the prognosis of ductal carcinoma in situ (DCIS).

Methods

From January 2002 to April 2008, preoperative MRI was performed for evaluating the extent of disease in 26 patients with DCIS. The MRI findings, the modified Van Nuys scores and the clinicopathological results were reviewed. The accuracy of breast MRI was analyzed with respect to the detection of tumor multiplicity and disease extending into the nipple, and this was compared with that of mammography.

Results

For detecting multiple lesions, the sensitivity and specificity of breast MRI were 25.0% and 86.4%, respectively, and the results of mammography were 0.0% and 86.4%, respectively. The accuracy of breast MRI was 76.9% and that of mammography was 73.1%. For detecting tumor extension into the nipple, the sensitivity and specificity of breast MRI was 100.0% and 80.0%, respectively, and that for mammography was 0.0% and 92.0%. respectively. The accuracy of MRI was 80.8% and that for mammography was 88.5%. The MRI final assessment was not associated with the modified Van Nuys score (p=0.474).

Conclusion

For detecting the disease extent of DCIS, preoperative breast MRI is not superior to mammography due to the low specificity and accuracy of MRI. MRI did not show a definite ability to predict the prognosis of DCIS in this study.

Keywords: Ductal carcinoma in situ, Modified Van Nuys Prognostic Index, Magnetic Resonance Imaging

Figures and Tables

Table 1

Characteristics of the patients with ductal carcinoma in situ

ER=estrogen receptor; PR=progesteron receptor.

Table 2

Accuracy of preoperative MRI and MMG examinations for multiplicity of ductal carcinoma in situ

MRI=magnetic resonance imaging; MMG=mammography.

^*sensitivity=25.0%, specificity=86.4%, accuracy=76.9%; ^†sensitivity=0.0%, specificity=86.4%, accuracy=73.1%.

Table 3

Accuracy of preoperative MRI and MMG examinations for nipple extension of ductal carcinoma in situ

MRI=magnetic resonance imaging; MMG=mammography.

^*sensitivity=100.0%, specificity=80.0%, accuracy=80.8%; ^†sensitivity=0.0%, specificity=92.0%, accuracy=88.5%.

Table 4

The factors of modified Van Nuys prognostic Index and final assessment of MRI of 26 patients with DCIS

DCIS=ductal carcinoma in situ; MVNPI=modified Van Nuys prognostic index; MRI=magnetic resonance imaging.

Table 5

Relationship between MRI final assessment and MVNPI subgroup

MRI=magnetic resonance imaging; MVNPI=modified Van Nuys prognostic index.

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