Magnetic resonance imaging of ductal carcinoma in situ: what is its clinical application? A review

BackgroundAfter breast-conserving surgery of ductal carcinoma in situ (DCIS) of the breast or invasive breast carcinoma with an extensive intraductal component, tumor-positive surgical margins are frequently found. Therefore, the extent of the intraductal disease needs to be accurately determined preoperatively.MethodsData for this review were identified by search of PubMed. Reference lists of selected articles were cross-searched for additional literature.ResultsDCIS is accurately detected with magnetic resonance imaging (MRI), but the typical malignant features are inconsistently seen and most often in high-grade DCIS or in DCIS with a small invasive component. The histopathologic extent of DCIS is more accurately demonstrated with MRI. However, overestimation due to benign proliferative lesions does frequently occur. An improved depiction of DCIS could lead to improved preoperative staging. Conversely, the identification of more extensive disease on MRI could give rise to unnecessary interventions. Therefore, MRI should be used carefully and preferable in specialized and experienced centers.ConclussionTo date, there is no evidence that the use of MRI improves outcomes (ie, decreases recurrence rates) in patients with DCIS.