Background: Ductal carcinoma in situ (DCIS) is often reclassified as invasive cancer in the final pathology report of the surgical specimen. It is of significant clinical relevance to acknowledge the possibility of underestimating invasive disease when utilizing preoperative biopsies for a DCIS diagnosis. In cases where such histologic upgrades occur, it is imperative to consider them in the preoperative planning process, including the potential inclusion of sentinel lymph node biopsy due to the risk of axillary lymph node metastasis. Purpose: To assess the capability of breast multiparametric magnetic resonance imaging (MP-MRI) in differentiating between pure DCIS and microinvasive carcinoma (MIC). Material and methods: Between January 2018 and November 2022, this retrospective study enrolled patients with biopsy-proven DCIS who had undergone preoperative breast MP-MRI. We assessed various MP-MRI features, including size, morphology, margins, internal enhancement pattern, extent of disease, presence of peritumoral edema, time-intensity curve value, diffusion restriction, and ADC value. Subsequently, a logistic regression analysis was conducted to explore the association of these features with the pathological outcome. Results: Of 129 patients with biopsy-proven DCIS, 36 had foci of micro-infiltration on surgical specimens and eight were diagnosed with invasive ductal carcinoma (IDC). The presence of micro-infiltration foci was significantly associated with several MP-MRI features, including tumor size (P <0.001), clustered ring enhancement (P <0.001), segmental distribution (P <0.001), diffusion restriction (P = 0.005), and ADC values <1.3 × 10-3 mm2/s (P = 0.004). Conclusion: Breast MP-MRI has the potential to predict the presence of micro-infiltration foci in biopsy-proven DCIS and may serve as a valuable tool for guiding therapeutic planning.

Could breast multiparametric MRI discriminate between pure ductal carcinoma in situ and microinvasive carcinoma? / Rizzo, Veronica; Cicciarelli, Federica; Galati, Francesca; Moffa, Giuliana; Maroncelli, Roberto; Pasculli, Marcella; Pediconi, Federica. - In: ACTA RADIOLOGICA. - ISSN 1600-0455. - (2024), p. 2841851231225807. [10.1177/02841851231225807]

Could breast multiparametric MRI discriminate between pure ductal carcinoma in situ and microinvasive carcinoma?

Veronica Rizzo
Primo
;
Federica Cicciarelli
Secondo
;
Francesca Galati;Giuliana Moffa;Roberto Maroncelli;Marcella Pasculli;Federica Pediconi
Ultimo
2024

Abstract

Background: Ductal carcinoma in situ (DCIS) is often reclassified as invasive cancer in the final pathology report of the surgical specimen. It is of significant clinical relevance to acknowledge the possibility of underestimating invasive disease when utilizing preoperative biopsies for a DCIS diagnosis. In cases where such histologic upgrades occur, it is imperative to consider them in the preoperative planning process, including the potential inclusion of sentinel lymph node biopsy due to the risk of axillary lymph node metastasis. Purpose: To assess the capability of breast multiparametric magnetic resonance imaging (MP-MRI) in differentiating between pure DCIS and microinvasive carcinoma (MIC). Material and methods: Between January 2018 and November 2022, this retrospective study enrolled patients with biopsy-proven DCIS who had undergone preoperative breast MP-MRI. We assessed various MP-MRI features, including size, morphology, margins, internal enhancement pattern, extent of disease, presence of peritumoral edema, time-intensity curve value, diffusion restriction, and ADC value. Subsequently, a logistic regression analysis was conducted to explore the association of these features with the pathological outcome. Results: Of 129 patients with biopsy-proven DCIS, 36 had foci of micro-infiltration on surgical specimens and eight were diagnosed with invasive ductal carcinoma (IDC). The presence of micro-infiltration foci was significantly associated with several MP-MRI features, including tumor size (P <0.001), clustered ring enhancement (P <0.001), segmental distribution (P <0.001), diffusion restriction (P = 0.005), and ADC values <1.3 × 10-3 mm2/s (P = 0.004). Conclusion: Breast MP-MRI has the potential to predict the presence of micro-infiltration foci in biopsy-proven DCIS and may serve as a valuable tool for guiding therapeutic planning.
2024
Breast cancer; clustered ring enhancement; ductal carcinoma in situ; microinvasion; microinvasive carcinoma; multiparametric magnetic resonance imaging
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Could breast multiparametric MRI discriminate between pure ductal carcinoma in situ and microinvasive carcinoma? / Rizzo, Veronica; Cicciarelli, Federica; Galati, Francesca; Moffa, Giuliana; Maroncelli, Roberto; Pasculli, Marcella; Pediconi, Federica. - In: ACTA RADIOLOGICA. - ISSN 1600-0455. - (2024), p. 2841851231225807. [10.1177/02841851231225807]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1699770
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