Doyle Anthony James, Prakash Sharath, Wang Kaye, Cranshaw Isaac, Taylor Eletha, Oldfield Robyn
Radiology Department, Auckland City Hospital, Auckland, New Zealand.
General Surgery, Auckland City Hospital, Auckland, New Zealand.
J Med Imaging Radiat Oncol. 2016 Apr;60(2):194-8. doi: 10.1111/1754-9485.12430. Epub 2016 Jan 25.
Ductal carcinoma in situ (DCIS) of the breast is commonly treated surgically. The intent of this study was to evaluate whether preoperative MRI could add to mammography in predicting the extent of the disease.
A series of patients with DCIS attending our surgical clinic for preoperative assessment were offered MRI as part of a prospective study. The extent of the disease indicated by mammography and MRI was compared with histopathology after definitive treatment. The null hypothesis was that MRI does not add to mammography in accurately predicting disease extent.
Fifty patients make up the basis of this report. Mammography was concordant with the pathology in 31/50. MRI and mammography combined were concordant in 43/50. This is a statistically significant difference (P = 0.01, Fisher's exact test). Upstaging to mastectomy by MRI was correct in 7/8 patients, but downstaging was correct in only 2/4.
The null hypothesis is rejected. MRI does add to mammography in accurately predicting the extent of DCIS. Upstaging by MRI is usually reliable.
乳腺导管原位癌（DCIS）通常采用手术治疗。本研究的目的是评估术前MRI在预测疾病范围方面是否能补充乳腺X线摄影的不足。
作为一项前瞻性研究的一部分，我们为一系列在外科门诊进行术前评估的DCIS患者提供了MRI检查。将乳腺X线摄影和MRI所示的疾病范围与确定性治疗后的组织病理学结果进行比较。原假设是MRI在准确预测疾病范围方面不能补充乳腺X线摄影的不足。
50例患者构成了本报告的基础。乳腺X线摄影与病理结果相符的有31/50。MRI和乳腺X线摄影联合检查与病理结果相符的有43/50。这是一个具有统计学意义的差异（P = 0.01，Fisher精确检验）。MRI将8例患者中的7例正确升级为乳房切除术，但在4例患者中只有2例正确降级。
原假设被拒绝。MRI在准确预测DCIS范围方面确实能补充乳腺X线摄影的不足。MRI升级通常是可靠的。
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