Calcified and Non-Calcified Ductal Carcinoma <i>in Situ</i>: Contrast-Enhanced MRI Features and Pathological Correlation

Abstract

Background: Early detection of ductal carcinoma in situ (DCIS) is essential for improving the prognosis of breast cancer. Among mammographically detected DCIS cases, approximately 10% - 20% of DCIS cases are manifested as non-calcified. Purpose: To evaluate differences in MRI findings and histological features between mammographically evident non-calcified and calcified DCIS. Material and Methods: This study included 84 cases of pathologically proven DCIS in 82 patients who underwent preoperative breast MRI. The lesions were divided into non-calcified and calcified DCIS according to the presence of calcifications on mammography. MRI features were analyzed according to the enhancement pattern. The pathologic features were also reviewed. Results: Among the 84 DCIS cases, 30 (36%) were classified as non-calcified DCIS, and 54 (64%) as calcified DCIS on mammography. On MRI, 27% (8/30) of non-calcified DCIS and 17% (9/54) calcified DCIS presented as mass enhancement, 73% (22/30) non-calcified DCIS and 83% (45/54) calcified DCIS presented as non-mass enhancements. No significant difference in the type of lesion was observed between non-calcified and calcified DCIS (p = 0.274). Histopathologically, high nuclear grade, presence of necrosis, and presence of HER-2 status were more common in calcified DCIS than in non-calcified DCIS (p < 0.05). Conclusion: There were no significant differences in MRI findings between non-calcified and calcified DCIS. However, calcified DCIS had more aggressive histological features than non-calcified DCIS.