PURPOSE: Magnetic resonance imaging (MRI) is an important tool for characterizing invasive breast cancer but has proven to be more challenging in the setting of ductal carcinoma in situ (DCIS). We investigated whether MRI features of DCIS reflect differences in biology and pathology. PATIENTS AND METHODS: Forty five of 100 patients with biopsy-proven DCIS who underwent MRI and had sufficient tissue to be characterized by pathologic (nuclear grade, presence of comedo necrosis, size, and density of disease) and immunohistochemical (IHC) findings (proliferation, Ki67; angiogenesis, CD34; and inflammation, CD68). Pathology and MRI features (enhancement patterns, distribution, size, and density) were analyzed using pairwise and canonical correlations. RESULTS: Histopathologic and IHC variables correlated with MRI features (r = 0.73). The correlation was largely due to size, density (by either MRI or pathology), and inflammation (P < .05). Most small focal masses were estrogen receptor-positive. MRI enhancement patterns that were clumped were more likely than heterogeneous patterns to be high-grade lesions. Homogenous lesions were large, high grade, and rich in macrophages. Presence of comedo necrosis and size could be distinguished on MRI (P < .05). MRI was most likely to over-represent the size of less dense, diffuse DCIS lesions. CONCLUSION: The heterogeneous presentation of DCIS on MRI reflects underlying histopathologic differences.
PURPOSE: Magnetic resonance imaging (MRI) is an important tool for characterizing invasive breast cancer but has proven to be more challenging in the setting of ductal carcinoma in situ (DCIS). We investigated whether MRI features of DCIS reflect differences in biology and pathology. PATIENTS AND METHODS: Forty five of 100 patients with biopsy-proven DCIS who underwent MRI and had sufficient tissue to be characterized by pathologic (nuclear grade, presence of comedo necrosis, size, and density of disease) and immunohistochemical (IHC) findings (proliferation, Ki67; angiogenesis, CD34; and inflammation, CD68). Pathology and MRI features (enhancement patterns, distribution, size, and density) were analyzed using pairwise and canonical correlations. RESULTS: Histopathologic and IHC variables correlated with MRI features (r = 0.73). The correlation was largely due to size, density (by either MRI or pathology), and inflammation (P < .05). Most small focal masses were estrogen receptor-positive. MRI enhancement patterns that were clumped were more likely than heterogeneous patterns to be high-grade lesions. Homogenous lesions were large, high grade, and rich in macrophages. Presence of comedo necrosis and size could be distinguished on MRI (P < .05). MRI was most likely to over-represent the size of less dense, diffuse DCIS lesions. CONCLUSION: The heterogeneous presentation of DCIS on MRI reflects underlying histopathologic differences.
Authors: Anjali S Kumar; Daniel F Chen; Alfred Au; Yunn-Yi Chen; Jessica Leung; Elisabeth R Garwood; Jessica Gibbs; Nola Hylton; Laura J Esserman Journal: Am J Surg Date: 2006-10 Impact factor: 2.565
Authors: Monica Morrow; Eric A Strom; Lawrence W Bassett; D David Dershaw; Barbara Fowble; J a y R Harris; Frances O'Malley; Stuart J Schnitt; S Eva Singletary; David P Winchester Journal: CA Cancer J Clin Date: 2002 Sep-Oct Impact factor: 508.702
Authors: Eline E Deurloo; Jincey D Sriram; Hendrik J Teertstra; Claudette E Loo; Jelle Wesseling; Emiel J Th Rutgers; Kenneth G A Gilhuijs Journal: Eur Radiol Date: 2012-02-26 Impact factor: 5.315
Authors: Kaoru Itakura; Juan Lessing; Theadora Sakata; Amy Heinzerling; Eline Vriens; Dorota Wisner; Michael Alvarado; Laura Esserman; Cheryl Ewing; Nola Hylton; E Shelley Hwang Journal: Clin Breast Cancer Date: 2011-03 Impact factor: 3.225
Authors: Anjali S Kumar; Daniel F Chen; Alfred Au; Yunn-Yi Chen; Jessica Leung; Elisabeth R Garwood; Jessica Gibbs; Nola Hylton; Laura J Esserman Journal: Am J Surg Date: 2006-10 Impact factor: 2.565
Authors: Habib Rahbar; Savannah C Partridge; Peter R Eby; Wendy B Demartini; Robert L Gutierrez; Sue Peacock; Constance D Lehman Journal: Eur Radiol Date: 2011-05-12 Impact factor: 5.315
Authors: Jing Luo; Brian S Johnston; Averi E Kitsch; Daniel S Hippe; Larissa A Korde; Sara Javid; Janie M Lee; Sue Peacock; Constance D Lehman; Savannah C Partridge; Habib Rahbar Journal: Radiology Date: 2017-09-14 Impact factor: 11.105
Authors: Maxine S Jochelson; D David Dershaw; Janice S Sung; Alexandra S Heerdt; Cynthia Thornton; Chaya S Moskowitz; Jessica Ferrara; Elizabeth A Morris Journal: Radiology Date: 2012-12-06 Impact factor: 11.105
Authors: Michael R Harowicz; Ashirbani Saha; Lars J Grimm; P Kelly Marcom; Jeffrey R Marks; E Shelley Hwang; Maciej A Mazurowski Journal: J Magn Reson Imaging Date: 2017-02-09 Impact factor: 4.813
Authors: S A Jansen; S D Conzen; X Fan; T Krausz; M Zamora; S Foxley; J River; G M Newstead; G S Karczmar Journal: Phys Med Biol Date: 2008-09-09 Impact factor: 3.609
Authors: Esther H Lips; Rita A Mukhtar; Christina Yau; Jorma J de Ronde; Chad Livasy; Lisa A Carey; Claudette E Loo; Marie-Jeanne T F D Vrancken-Peeters; Gabe S Sonke; Donald A Berry; Laura J Van't Veer; Laura J Esserman; Jelle Wesseling; Sjoerd Rodenhuis; E Shelley Hwang Journal: Breast Cancer Res Treat Date: 2012-09-08 Impact factor: 4.872