Breast-Conserving Surgery Using Projection and Reproduction Techniques of Surgical-Position Breast MRI in Patients with Ductal Carcinoma In Situ of the Breast

BackgroundIn this study, we report a breast-conserving surgery (BCS) approach that uses projection and reproduction techniques of breast MRI obtained in the surgical position to the breast surface in patients with ductal carcinoma in situ (DCIS) of the breast.Study DesignBetween February 2005 and January 2007, a total of 104 patients with operable breast cancer at our hospital had surgical-position breast MRI examinations. The 24 patients with relatively localized DCIS received BCS using the projection and reproduction techniques of the surgical-position breast MRI. During the same time period, 28 patients with relatively localized DCIS in whom prone-position breast MRI was performed, had conventional BCS using mammography-guided hookwires. In this study, we compared the surgical outcomes of our surgical approach with those of the conventional approach in a total of 52 patients with relatively localized DCIS.ResultsAverage volume of the pathologic specimens in the new technique group (27.5 cm3) was substantially smaller than that in the conventional BCS group (57.6 cm3, p = 0.0007). In addition, the positive margin rate was substantially lower in the new technique group (12.5%) than in the conventional BCS group (39.3%; p = 0.029).ConclusionsThis study demonstrates that BCS can be done guided by the precise projection and reproduction techniques of the lesion obtained by surgical-position breast MRI. To the best of our knowledge, this is the first report of BCS technique for DCIS in this manner. Our surgical approach can be clinically useful in surgical planning and management in patients with DCIS.