In situ disease on breast MRI

Abstract

Ductal Carcinoma in Situ is a non-invasive form of breast cancer, in which malignant ductal epithelial cells proliferate, but do not invade through the basement membrane. It is a heterogeneous disease, and is a non-obligate precursor to invasive carcinoma. With the advent of screening mammography the incidence of DCIS has greatly increased. MRI is the most sensitive examination for detecting DCIS. The most common presenting morphology of DCIS is nonmass enhancement, with a clumped internal enhancement pattern and with a segmental distribution pattern. There is great variety in the kinetic patterns of DCIS, and therefore assessment must be based on morphology. Additional tools, such as diffusion weighted imaging have been shown to be promising in helping detect clinically relevant DCIS.