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Preoperative prediction of the size of pure ductal carcinoma in situ using three imaging modalities as compared to histopathological size: does magnetic resonance imaging add value?

  • Epidemiology
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Abstract

Purpose

The purpose of this study was to evaluate whether magnetic resonance imaging (MRI) and ultrasonography add value to traditional mammography in an Asian population with ductal carcinoma in situ (DCIS).

Methods

Data of 244 patients with pure DCIS treated at Severance Hospital between 2013 and 2015 were analyzed retrospectively. Data extracted included age, preoperative diagnosis, tumor size on preoperative imaging studies, and final histopathological tumor type and size, including hormone receptor status. The extent of correlation between imaging and histopathological tumor sizes was evaluated using a variety of methods, including Bland–Altman analysis.

Results

The mean patient age was 52.39 years (SD = 10.31). The mean measurements of the tumor on preoperative ultrasonography, mammography, MRI, and histopathology were 1.80 (SD = 1.23) cm, 2.97 (SD = 1.92) cm, 2.53(SD = 1.84) cm, and 1.88 (SD = 1.36) cm, respectively. The mean differences in tumor size between ultrasonography, mammography, and MRI compared with histopathology were −0.09 (SD = 1.39), 1.09 (SD = 1.89), and 0.65 (SD = 1.78), respectively. The correlation between the sizes was significant with r values for ultrasonography, mammography, and MRI of 0.447 (SE = 0.061), 0.375 (SE = 0.042), and 0.409 (SE = 0.043), respectively. Mammography and MRI estimated tumor size significantly better for patients older than 50 years (p = 0.045 and <0.001, respectively). Mammography also provided good estimation for patients with a body mass index under 25 (p = 0.041).

Conclusion

MRI is better at estimation of histopathological DCIS size compared with mammography. However, ultrasonography had better estimation compared with MRI and mammography, probably owing to the high breast density in this population.

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Acknowledgements

We acknowledge the radiology department for their assistance in evaluating the images, and the Korean Ministry of Education for funding the project. We also acknowledge the records department for giving us access to data used in this study.

Funding

This research was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2015S1A5B8036349). No organization related to this study has funded specific authors for any function.

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Authors and Affiliations

  1. Department of Surgery, University of Nairobi, Nairobi, Kenya

    Ojuka Kinyuru Daniel

  2. Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea

    Sung Mook Lim, Joo Heung Kim, Hyung Seok Park, Seho Park & Seung Il Kim

  3. Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, Republic of Korea

    Seho Park

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  1. Ojuka Kinyuru Daniel
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Correspondence to Ojuka Kinyuru Daniel or Seho Park.

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All authors declare no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board of Severance Hospital, Seoul, Republic of Korea [No. 4-2016-0330]. The requirement for written informed consent was waived and personal information was anonymized and deidentified prior to analysis. This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Daniel, O.K., Lim, S.M., Kim, J.H. et al. Preoperative prediction of the size of pure ductal carcinoma in situ using three imaging modalities as compared to histopathological size: does magnetic resonance imaging add value?. Breast Cancer Res Treat 164, 437–444 (2017). https://doi.org/10.1007/s10549-017-4252-2

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