Schouten van der Velden Arjan P, Schlooz-Vries Margrethe S, Boetes Carla, Wobbes Theo
Department of Surgical Oncology, Radboud University Nijmegen, The Medical Center, Nijmegen, the Netherlands.
Am J Surg. 2009 Aug;198(2):262-9. doi: 10.1016/j.amjsurg.2009.01.010. Epub 2009 Apr 17.
After 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.
Data for this review were identified by search of PubMed. Reference lists of selected articles were cross-searched for additional literature.
DCIS 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.
[corrected] To date, there is no evidence that the use of MRI improves outcomes (ie, decreases recurrence rates) in patients with DCIS.
在对乳腺导管原位癌（DCIS）或具有广泛导管内成分的浸润性乳腺癌进行保乳手术后，经常会发现肿瘤阳性手术切缘。因此，术前需要准确确定导管内病变的范围。
通过检索PubMed确定本综述的数据。对所选文章的参考文献列表进行交叉检索以获取更多文献。
磁共振成像（MRI）能准确检测出DCIS，但典型的恶性特征并不一致，且最常见于高级别DCIS或伴有小浸润成分的DCIS。MRI能更准确地显示DCIS的组织病理学范围。然而，由于良性增生性病变导致的高估经常发生。对DCIS的更好描绘可能会改善术前分期。相反，在MRI上发现更广泛的疾病可能会导致不必要的干预。因此，MRI应谨慎使用，最好在专业且经验丰富的中心使用。
[已修正] 迄今为止，没有证据表明使用MRI能改善DCIS患者的预后（即降低复发率）。
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