Diagnosis of ductal carcinoma in situ using contrast-enhanced magnetic resonance mammography compared with conventional mammography.
OBJECTIVE
The objective of this study is to compare mammography with magnetic resonance mammography (MRM) in the diagnosis of histopathologically verified subtypes of ductal carcinoma in situ (DCIS).


METHODS
All patients with verified pure DCIS lesions (no signs of invasion or microinvasion) after surgery were identified between 2004 and 2006. Selection criteria were performed mammography and MRM at our institute prior to surgery resulting in a cohort of 33 patients (mean patient age, 60 years; mean lesion size, 15 mm).


RESULTS
Magnetic resonance mammography enabled identification of DCIS in 29 of 33 patients with histopathologically verified pure DCIS (7 G1, 13 G2, and 9 G3 subtypes), giving an overall sensitivity of 87.9% for this patient cohort. Four DCIS lesions (two G1 and two G2) up to 5 mm diameter or smaller were not detected by MRM. In mammography, 21 of the 33 patients revealed suspicious outcome (including all lesions not detected by MRM), demonstrating an overall sensitivity of 63.6%. The remaining 12 mammographically occult DCIS lesions (three G1 subtypes, four G2 subtypes, five G3 subtypes) were all identified in MRM.


CONCLUSIONS
Magnetic resonance mammography can diagnose mammographically visible and also occult DCIS lesions without microcalcifications. Only small DCIS foci with microcalcifications could additionally be verified by mammography supposing MRM as a diagnostic approach.
Vag
Tibor
T
Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, 07747 Jena, Germany. tibor.vag@med.uni-jena.de
Baltzer
Pascal A T
PA
Renz
Diane M
DM
Pfleiderer
Stefan O R
SO
Gajda
Mieczyslaw
M
Camara
Oumar
O
Kaiser
Werner A
WA
D000328:Adult; D000368:Aged; D044584:Carcinoma, Ductal / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D019786:Gadolinium DTPA