Biologic significance of false-positive magnetic resonance imaging enhancement in the setting of ductal carcinoma in situ.
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.
Kumar
Anjali S
AS
Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
Chen
Daniel F
DF
Au
Alfred
A
Chen
Yunn-Yi
YY
Leung
Jessica
J
Garwood
Elisabeth R
ER
Gibbs
Jessica
J
Hylton
Nola
N
Esserman
Laura J
LJ
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
D015703:Antigens, CD; D018952:Antigens, CD34; D015214:Antigens, Differentiation, Myelomonocytic; D019394:Ki-67 Antigen; C067980:CD68 antigen, human; D000097382:CD68 Molecule