Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 5-6, Pages: 402-408
https://doi.org/10.2298/SARH1306402N
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The role of breast magnetic resonance imaging in the diagnosis of ductal carcinoma in situ
Nadrljanski Mirjan (Institut za onkologiju i radiologiju Srbije, Klinika za radiološku onkologiju i dijagnostiku, Beograd)
Milošević Zorica (Institut za onkologiju i radiologiju Srbije, Klinika za radiološku onkologiju i dijagnostiku, Beograd + Katedra za radiologiju, Medicinski fakultet, Beograd)
PlešinacKarapandžić Vesna (Institut za onkologiju i radiologiju Srbije, Klinika za radiološku onkologiju i dijagnostiku, Beograd + Katedra za radiologiju, Medicinski fakultet, Beograd)
Goldner Branislav (Medicinski fakultet, Katedra za radiologiju, Beograd)
Ductal carcinoma in situ (DCIS), the noninvasive breast malignant tumor
originates from the terminal ductallobular units (TDLU). The typical feature
of DCSI is the formation of calcifications. Up to 90% of DCIS are diagnosed
on mammographic examinations, as clinically asymptomatic. Between 10% and 20%
of DCIS remain mammographically occult due to the lack of calcifications and/
or small tumor dimensions. Contrastenhanced breast magnetic resonance
imaging (MRI) detects mammographically occult breast lesions, thus defining
morphologic features of the lesion and the dynamics of signal intensity
changes due to contrast enhancement. Distribution of contrast enhancement -
signal intensity increase in DCIS most frequently includes segmental, ductal
and linear patterns, followed by regional enhancement pattern, while the
intralesional contrast uptake most frequently includes the nodular pattern
with the areas of confluence. Post contrast signal intensity increase in
DCIS is most frequently fast in the initial phase (washin), while the whole
dynamic of contrastenhancement includes either of the three possible
timeintensity curve (TIC) types (persistent, plateau or washout), although
the plateau TIC is considered to be more frequent. Breast MRI has high
sensitivity in the diagnosis of invasive breast cancer, varying from 90% to
100%; the sensitivity in the diagnosis of DCIS is lower (7796%). For the
time being, the primary role of MRI in DCIS is planning of breastconserving
surgery (BCS) for the evaluation of lesion extension. Further development of
MRI in the diagnosis of DCIS includes the implementation of the principles
of functional and molecular imaging.
Keywords: breast, magnetic resonance imaging, carcinoma, intraductal