Abstract
BackgroundPreoperative breast magnetic resonance imaging (MRI) provides more information than mammography and ultrasonography for determining the surgical plan for patients with breast cancer. This study aimed to determine whether breast MRI is more useful for patients with ductal carcinoma in situ (DCIS) lesions than for those with invasive ductal carcinoma (IDC).MethodsA total of 1113 patients with breast cancer underwent mammography, ultrasonography, and additional breast MRI before surgery. The patients were divided into 2 groups: DCIS (n = 199) and IDC (n = 914), and their clinicopathological characteristics and oncological outcomes were compared. Breast surgery was classified as follows: conventional breast-conserving surgery (Group 1), partial mastectomy with volume displacement (Group 2), partial mastectomy with volume replacement (Group 3), and total mastectomy with or without reconstruction (Group 4). The initial surgical plan (based on routine mammography and ultrasonography) and final surgical plan (after additional breast MRI) were compared between the 2 groups. The change in surgical plan was defined as group shifting between the initial and final surgical plans.ResultsChanges (both increasing and decreasing) in surgical plans were more common in the DCIS group than in the IDC group (P < 0.001). These changes may be attributed to the increased extent of suspicious lesions on breast MRI, detection of additional daughter nodules, multifocality or multicentricity, and suspicious findings on mammography or ultrasonography but benign findings on breast MRI. Furthermore, the positive margin incidence in frozen biopsy was not different (P = 0.138).ConclusionsPreoperative breast MRI may provide more information for determining the surgical plan for patients with DCIS than for those with IDC.
Highlights
Preoperative breast magnetic resonance imaging (MRI) provides more information than mammography and ultrasonography for determining the surgical plan for patients with breast cancer
We evaluated the usefulness of preoperative breast MRI in determining the surgical plan for patients with breast cancer [14]
The incidence of bilateral breast cancer was higher in the ductal carcinoma in situ (DCIS) group (DCIS, 7.0% vs. invasive ductal carcinoma (IDC), 3.3%; P = 0.014), and triplenegative breast cancer was more frequent in the IDC group (DCIS, 5.5% vs. IDC, 9.3%; P = 0.002)
Summary
Preoperative breast magnetic resonance imaging (MRI) provides more information than mammography and ultrasonography for determining the surgical plan for patients with breast cancer. This study aimed to determine whether breast MRI is more useful for patients with ductal carcinoma in situ (DCIS) lesions than for those with invasive ductal carcinoma (IDC). Compared with mammography or ultrasonography, it can provide additional information for diagnosing ductal carcinoma in situ (DCIS) [1,2,3]. In triple-negative breast cancer, the breast lesion may appear round, which can be misinterpreted as a benign lesion [11,12,13] In those cases, additional preoperative breast MRI can provide more important information
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