Efficacy of breast MRI for surgical decision in patients with breast cancer: ductal carcinoma in situ versus invasive ductal carcinoma.
BACKGROUND
Preoperative breast magnetic resonance imaging (MRI) provides more information than mammography and ultrasonography for determining the surgical plan for patients with breast cancer. This study aimed to determine whether breast MRI is more useful for patients with ductal carcinoma in situ (DCIS) lesions than for those with invasive ductal carcinoma (IDC).


METHODS
A total of 1113 patients with breast cancer underwent mammography, ultrasonography, and additional breast MRI before surgery. The patients were divided into 2 groups: DCIS (n = 199) and IDC (n = 914), and their clinicopathological characteristics and oncological outcomes were compared. Breast surgery was classified as follows: conventional breast-conserving surgery (Group 1), partial mastectomy with volume displacement (Group 2), partial mastectomy with volume replacement (Group 3), and total mastectomy with or without reconstruction (Group 4). The initial surgical plan (based on routine mammography and ultrasonography) and final surgical plan (after additional breast MRI) were compared between the 2 groups. The change in surgical plan was defined as group shifting between the initial and final surgical plans.


RESULTS
Changes (both increasing and decreasing) in surgical plans were more common in the DCIS group than in the IDC group (P <  0.001). These changes may be attributed to the increased extent of suspicious lesions on breast MRI, detection of additional daughter nodules, multifocality or multicentricity, and suspicious findings on mammography or ultrasonography but benign findings on breast MRI. Furthermore, the positive margin incidence in frozen biopsy was not different (P = 0.138).


CONCLUSIONS
Preoperative breast MRI may provide more information for determining the surgical plan for patients with DCIS than for those with IDC.
['Lee|Jeeyeon|J|', 'Jung|Jin Hyang|JH|', 'Kim|Wan Wook|WW|', 'Park|Chan Sub|CS|', 'Lee|Ryu Kyung|RK|', 'Kim|Hye Jung|HJ|', 'Kim|Won Hwa|WH|', 'Park|Ho Yong|HY|http://orcid.org/0000-0002-4380-0089']
D000368:Aged D001943:Breast Neoplasms D018270:Carcinoma, Ductal, Breast D002285:Carcinoma, Intraductal, Noninfiltrating D003287:Contrast Media D003937:Diagnosis, Differential D005260:Female D006801:Humans D008279:Magnetic Resonance Imaging D008327:Mammography D000072662:Margins of Excision D015412:Mastectomy, Segmental D008875:Middle Aged
Breast Ductal carcinoma Magnetic resonance imaging Surgical plan