Michael Lallemand1, Morgan Barron2, Jason Bingham2, Andrew Mosier3, Mark Hardin2, Vance Sohn2. 1. Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Dr., Joint Base Lewis-McChord, Tacoma, WA 98431, USA. Electronic address: Michael.s.lallemand.mil@mail.mil. 2. Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Dr., Joint Base Lewis-McChord, Tacoma, WA 98431, USA. 3. Department of Radiology, Madigan Army Medical Center, Tacoma, WA, USA.
Abstract
BACKGROUND: The optimal role of breast magnetic resonance imaging (MRI) in the management of ductal carcinoma in situ (DCIS) remains controversial. We sought to better define the impact of breast MRIs when utilized during the workup of DCIS. METHODS: Patients with biopsy-proven DCIS without any additional invasive disease were prospectively enrolled in the multidisciplinary breast cancer pathway and comprised the study group. Patients who met any additional criteria for MRI screening were excluded. RESULTS: From 2008 to 2014, 93 women met the inclusion criteria. 81 patients underwent MRI as part of their workup. One patient benefited from MRI via identification of occult malignancy not previously identified. 35 MRIs identified no additional information whereas 46 had additional findings. These findings led to 23 procedures and 16 negative biopsies; recommendations for 16 radiographic studies that were normal; and influenced nodal sampling in 7 women with 1 positive metastatic focus. CONCLUSIONS: The routine use of breast MRI for women diagnosed with DCIS has limited benefit. Often, it leads to multiple procedures and studies that are clinically insignificant and delays surgical treatment. Published by Elsevier Inc.
BACKGROUND: The optimal role of breast magnetic resonance imaging (MRI) in the management of ductal carcinoma in situ (DCIS) remains controversial. We sought to better define the impact of breast MRIs when utilized during the workup of DCIS. METHODS:Patients with biopsy-proven DCIS without any additional invasive disease were prospectively enrolled in the multidisciplinary breast cancer pathway and comprised the study group. Patients who met any additional criteria for MRI screening were excluded. RESULTS: From 2008 to 2014, 93 women met the inclusion criteria. 81 patients underwent MRI as part of their workup. One patient benefited from MRI via identification of occult malignancy not previously identified. 35 MRIs identified no additional information whereas 46 had additional findings. These findings led to 23 procedures and 16 negative biopsies; recommendations for 16 radiographic studies that were normal; and influenced nodal sampling in 7 women with 1 positive metastatic focus. CONCLUSIONS: The routine use of breast MRI for women diagnosed with DCIS has limited benefit. Often, it leads to multiple procedures and studies that are clinically insignificant and delays surgical treatment. Published by Elsevier Inc.
Entities:
Keywords:
DCIS; Ductal carcinoma in situ; MRI; Screening
Authors: Diana L Lam; Jacob Smith; Savannah C Partridge; Adrienne Kim; Sara H Javid; Daniel S Hippe; Constance D Lehman; Janie M Lee; Habib Rahbar Journal: Acad Radiol Date: 2019-07-05 Impact factor: 3.173
Authors: K B I M Keymeulen; S M E Geurts; M B I Lobbes; E M Heuts; L E M Duijm; L F S Kooreman; A C Voogd; V C G Tjan-Heijnen Journal: Br J Surg Date: 2019-08-06 Impact factor: 6.939