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Open Access Research article

Magnetic resonance imaging in size assessment of invasive breast carcinoma with an extensive intraductal component

Arjan P Schouten van der Velden1*, Carla Boetes2, Peter Bult3 and Theo Wobbes1

Author Affiliations

1 Department of Surgical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

2 Department of Radiology, Maastricht University Medical Centre, Nijmegen, the Netherlands

3 Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

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BMC Medical Imaging 2009, 9:5  doi:10.1186/1471-2342-9-5

Published: 7 April 2009

Abstract

Background

Breast-conserving treatment of invasive breast carcinoma with an extensive intraductal component (EIC) is associated with DCIS-involved surgical margins and therefore it has an increased recurrence rate. EIC is a non-palpable lesion of which the size is frequently underestimated on mammography. This study was undertaken to evaluate the accuracy of MRI in size assessment of breast cancer with EIC.

Methods

23 patients were identified and the mammographic (n = 21) and MR (n = 23) images were re-reviewed by a senior radiologist. Size on MR images was compared with histopathological tumour extent.

Results

The correlation of radiological size with histopathological size was r = 0.20 in mammography (p = 0.39) compared to r = 0.65 in MRI (p < 0.01). Mammography underestimated histopathological tumour size in 62%. MR images over- or underestimated tumour size in 22% and 30% of the cases, respectively. In poorly differentiated EIC, MRI adequately estimated the extent more often compared to moderately differentiated EIC (60% versus 25%, respectively).

Conclusion

Size assessment of MRI imaging was more accurate compared to mammography. This was predominantly true for poorly differentiated EIC.