S-Space College of Medicine/School of Medicine (의과대학/대학원) Surgery (외과학전공) Journal Papers (저널논문_외과학전공)
Limitations of Conventional Contrast-enhanced MRI in Selecting Sentinel Node Biopsy Candidates among DCIS Patients
- Moon, Hyeong-Gon; Han, Wonshik; Lee, Jong Won; Ko, Eunyoung; Yu, Jong-Han; Lyou, Chae Yeon; Hwang, Ki-Tae; Noh, Dong-Young; Moon, Woo Kyung; Jung, So-Youn; Kim, Eun-Kyu
- Issue Date
- KOREAN BREAST CANCER SOC
- JOURNAL OF BREAST CANCER; Vol.13(2); 154-159
- Breast neoplasms; Magnetic resonance imaging; Sentinel lymph node biopsy; Noninfiltrating intraductal carcinoma
- Purpose: A better predictive model for occult invasive disease in ductal carcinoma in situ (DCIS) patients is essential to guide the tailored use of sentinel node biopsies. We hypothesized that recent improvement of contrast-enhanced breast magnetic resonance imaging (MRI) could provide more accurate information on the presence of occult invasion in DCIS patients. Methods: From a prospectively maintained database, we identified 143 DCIS patients diagnosed with needle biopsies in whom MRI images were available. Results: Sixty-five patients (45.5%) were upstaged to invasive carcinoma after curative surgery. Ultrasonographic lesion size, mass-appearance on mammography, type of needle used, and the presence of suspicious microinvasive foci were associated with increased likelihood of upstaging. Among the features of MRI, only mass-appearance was significantly associated with the presence of invasive disease (p=0.002). However, up to 50% of masses in MRI cases had mass-appearance on mammography as well. Other morphologic and pharmacokinetic features of MRI, such as shape, margin, and patterns of enhancement and washout, did not have a significant association. Conclusion: Among various morphologic and pharmacokinetic parameters of contrast-enhanced MRI, only mass-appearance was associated with occult invasive disease. Our results show the limitations of current contrast-enhanced MRI in predicting invasive disease in patients with preoperative diagnoses of DCIS.