Dorota Jakubowski Wisner1, Belinda Chang1, Hilda Tso1, Christopher Flowers1, Bonnie N. Joe1, Juan Lessing2, Jessica Gibbs1, Kaoru Itakura3, Shelley Hwang3, Nola Hylton1
1Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA; 2School of Medicine, University of California, San Francisco, San Francisco, CA, USA; 3Surgery, University of California, San Francisco, San Francisco, CA, USA
In this study we evaluate the ability of breast MRI to predict occult invasion in patients initially diagnosed with pure ductal carcinoma in situ (DCIS). A comprehensive search of our institutions archives identified 51 preoperative MRI scans obtained after a core-biopsy diagnosis of DCIS. A radiologist blinded to surgical histopathology categorized these lesions and estimated likelihood of occult invasion. Results demonstrate 92% sensitivity, 58% specificity and 96% negative predictive value for occult invasion. These findings suggest that a negative preoperative MRI may assist risk stratification, affecting such decisions as surgical management and need for sentinel lymph node biopsy.