MORPHO-DYNAMIC AND FUNCTIONAL BREAST MRI FEATURES IN THE ASSESSMENT OF DUCTAL CARCINOMA IN SITU (DCIS) AND INVASIVE DUCTAL CARCINOMA (IDC) IN POSTMENOPAUSAL FEMALE PATIENTS

BREAST MRI IN DCIS AND IDC IN POSTMENOPAUSAL PATIENTS

Abstract

ABSTRACT

Introduction: Most frequent histologic types of breast cancer include invasive ductal carcinoma (IDC) and its most common precursor: ductal carcinoma in situ (DCIS). Based on morpho-dynamic and functional parameters: lesion size, initial signal intensity enhancement (wash-in), time-intensity curve (TIC) type, apparent diffusion coefficient (ADC), and positive enhancement integral (PEI), breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) allows the differentiation between IDC and in situ lesions in postmenopausal female patients.

Methods: A single-center retrospective study included 40 postmenopausal female patients with histopathologically confirmed diagnosis (DCIS n₁=20; IDC n₂=20), examined with full diagnostic protocol (FDP) on 1.5T and 3T MRI scanners. The SPSS 21.0 software package was used for the statistical analysis of the defined parameters in two predefined subgroups.

Results: Tumor size was significantly larger (p<0.001) in patients with DCIS. The IDC group showed significantly higher wash-in and PEI values (p<0.001). ADC was significantly higher (p<0.001) in DCIS. There was a statistically significant difference (p<0.05) in the TIC type distribution: TIC type 2 was predominant in patients with DCIS, while the TIC type 3 was predominant in patients with IDC.

Conclusion: Based on predefined morpho-dynamic and functional parameters, breast MRI may allow the differentiation between the two types of breast ductal carcinoma: IDC and DCIS. However, histopathological confirmation remains the “golden standard” in differentiation, taking into account the nature of the disease.

Keywords: DCE-MRI; ductal carcinoma in situ; invasive ductal carcinoma; morpho-dynamic parameters; functional parameters