title: Biologic significance of false-positive magnetic resonance imaging enhancement in the setting of ductal carcinoma in situ.
abstract: BACKGROUND
  Imaging patterns of benign proliferative processes often complicate the assessment of ductal carcinoma in situ (DCIS) by magnetic resonance imaging (MRI). We investigated the pathologic and biologic characteristics of false positive enhancement by breast MRI.
  
  
  METHODS
  DCIS (n = 45), benign (n = 5), and false-positive (MRI enhancement and nonmalignant pathology) (n = 10) cases were characterized by immunohistochemistry and MRI features.
  
  
  RESULTS
  For DCIS cases, images that overestimated pathologic size had heterogeneous enhancement on MR, were estrogen receptor positive, and were low grade by pathology. False-positives had higher rates of proliferation, angiogenesis, and inflammation compared with benign tissue but lower values than DCIS. Benign proliferative processes accounted for all false-positive and size overestimated cases.
  
  
  CONCLUSIONS
  Lesions that enhance on MRI have higher proliferation, angiogenesis, and inflammation compared with nonproliferative breast tissue. Benign proliferative processes often enhance on MRI and are difficult to differentiate from low-grade, ER+ DCIS lesions. False-positive MRI enhancement may reflect a spectrum of change within high-risk tissue.
authors.affiliation: Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Anjali S
authors.initials: AS
authors.lastname: Kumar
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Chen
authors.forename: Alfred
authors.initials: A
authors.lastname: Au
authors.forename: Yunn-Yi
authors.initials: YY
authors.lastname: Chen
authors.forename: Jessica
authors.initials: J
authors.lastname: Leung
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Garwood
authors.forename: Jessica
authors.initials: J
authors.lastname: Gibbs
authors.forename: Nola
authors.initials: N
authors.lastname: Hylton
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Esserman
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001941:Breast Diseases / Q000378:metabolism / Q000473:pathology*; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000378:metabolism* / Q000473:pathology*; D016022:Case-Control Studies; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D047368:Tumor Burden; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D018952:Antigens, CD34; D015214:Antigens, Differentiation, Myelomonocytic; D019394:Ki-67 Antigen; C067980:CD68 antigen, human; D000097382:CD68 Molecule