Proulx Francesca, Correa José A, Ferré Romuald, Omeroglu Atilla, Aldis Ann, Meterissian Sarkis, Mesurolle Benoît
1 Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, Montreal, QC, Canada.
2 Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada.
Br J Radiol. 2016;89(1058):20150543. doi: 10.1259/bjr.20150543. Epub 2015 Nov 16.
To retrospectively evaluate the accuracy of pre-operative breast MRI and mammography in determining the size of ductal carcinoma in situ (DCIS) compared with the histopathological results.
79 patients [mean age: 56.5 (standard deviation 10.2) years] with pathologically proven DCIS (79 lesions) obtained a bilateral mammogram and a pre-operative contrast-enhanced MRI. The accuracy of MRI and mammography to detect tumour size were estimated and compared, using histopathological size as the gold standard, on the subjects with measurements with both modalities (n = 60).
MRI detected 67 (85%) lesions, mammography detected 72 (91%) and both modalities detected 60 (76%). Median DCIS size detected by mammography vs MRI was smaller (1.55 vs 1.65 cm). Out of these 60 cases, compared with the histopathological size, the accuracy of MRI and mammography was 0.66 and 0.56, respectively (p = 0.045). MRI showed better accuracy than mammography for younger patients (age ≤ 50 years, p = 0.003). For tumour nuclear grade, there was a statistically significant difference for the intermediate level, with higher accuracy for MRI (p = 0.03).
MRI was more accurate than mammography in DCIS size assessment when visible, particularly in lesions of intermediate grade and in patients less than 50 years of age.
Breast MRI may help in management of DCIS of intermediate grade and in females less than 50 years of age.
回顾性评估术前乳腺磁共振成像（MRI）和乳腺钼靶摄影在确定导管原位癌（DCIS）大小方面的准确性，并与组织病理学结果进行比较。
79例经病理证实为DCIS（79个病灶）的患者[平均年龄：56.5（标准差10.2）岁]接受了双侧乳腺钼靶摄影和术前对比增强MRI检查。以组织病理学大小作为金标准，对两种检查方法均有测量值的60例患者，评估并比较MRI和乳腺钼靶摄影检测肿瘤大小的准确性。
MRI检测出67个（85%）病灶，乳腺钼靶摄影检测出72个（91%）病灶，两种检查方法均检测出60个（76%）病灶。乳腺钼靶摄影检测出的DCIS中位大小比MRI小（1.55 vs 1.65 cm）。在这60例病例中，与组织病理学大小相比，MRI和乳腺钼靶摄影的准确性分别为0.66和0.56（p = 0.045）。对于年轻患者（年龄≤50岁，p = 0.003），MRI显示出比乳腺钼靶摄影更高的准确性。对于肿瘤核分级，在中间级别存在统计学显著差异，MRI的准确性更高（p = 0.03）。
在可见的情况下，MRI在DCIS大小评估方面比乳腺钼靶摄影更准确，特别是在中级别的病灶和年龄小于50岁的患者中。
乳腺MRI可能有助于中级别的DCIS以及年龄小于50岁女性的管理。
