title: DCIS of the breast: The value of preoperative MRI.
abstract: BACKGROUND
  Ductal carcinoma in situ (DCIS) of the breast is commonly treated surgically. The intent of this study was to evaluate whether preoperative MRI could add to mammography in predicting the extent of the disease.
  
  
  METHODS
  A series of patients with DCIS attending our surgical clinic for preoperative assessment were offered MRI as part of a prospective study. The extent of the disease indicated by mammography and MRI was compared with histopathology after definitive treatment. The null hypothesis was that MRI does not add to mammography in accurately predicting disease extent.
  
  
  RESULTS
  Fifty patients make up the basis of this report. Mammography was concordant with the pathology in 31/50. MRI and mammography combined were concordant in 43/50. This is a statistically significant difference (P = 0.01, Fisher's exact test). Upstaging to mastectomy by MRI was correct in 7/8 patients, but downstaging was correct in only 2/4.
  
  
  CONCLUSIONS
  The null hypothesis is rejected. MRI does add to mammography in accurately predicting the extent of DCIS. Upstaging by MRI is usually reliable.
authors.affiliation: Radiology Department, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Anthony James
authors.identifier: http://orcid.org/0000-0003-4561-317X
authors.initials: AJ
authors.lastname: Doyle
authors.affiliation: Radiology Department, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Sharath
authors.initials: S
authors.lastname: Prakash
authors.affiliation: Radiology Department, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Kaye
authors.initials: K
authors.lastname: Wang
authors.affiliation: General Surgery, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Isaac
authors.initials: I
authors.lastname: Cranshaw
authors.affiliation: General Surgery, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Eletha
authors.initials: E
authors.lastname: Taylor
authors.affiliation: Histopathology, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Robyn
authors.initials: R
authors.lastname: Oldfield
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D015588:Observer Variation; D011300:Preoperative Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*
keywords: carcinoma; intraductal; magnetic resonance imaging; mammography; noninfiltrating