Diagnostic performance of minimum apparent diffusion coefficient value in differentiating the invasive breast cancer and ductal carcinoma in situ

Abstract

Background: This study is to explore the role of the minimum apparent diffusion coefficient (ADC-min) value in the diagnosis of invasive breast cancer and ductal carcinoma in situ (DCIS). Materials and Methods: A total of 196 breast cancer patients with pathologically verified lesions were included. They received diffusion-weighted imaging and dynamic breast magnetic resonance imaging before the pathological confirmation. The ADC-min value and its relationship with invasive ductal carcinoma (IDC), IDC-DCIS, and DCIS were analyzed. Results: Of the 196 breast cancer patients, there were 115 (58.67%) cases of IDC, 53 (27.04%) cases of IDC-DCIS, and 28 (14.29%) cases of DCIS. The mean ADC-min values for IDC, IDC-DCIS, and DCIS were (0.96 ± 0.16) × 10-3, (1.10 ± 0.13) × 10-3, and (1.24 ± 0.17) × 10-3 mm 2/s, respectively. The mean ADC-min value of IDC was significantly lower than that of IDC-DCIS and that of IDC-DCIS was significantly lower than that of DCIS (P < 0.01). The mean ADC-min value was also significantly different between invasive cancer and DCIS (P < 0.01). The mean ADC-min value can be used in the differential diagnosis of DCIS, with a cutoff point of 1.02 × 10-3 mm 2/s (sensitivity of 92.9% and specificity of 57.7%). Conclusions: The ADC-min values are significantly different among IDC, IDC-DCIS, and DCIS, with the lowest ADC-min values in IDC, followed by IDC-DCIS and DCIS. The ADC-min maybe used as a promising parameter to differentiate DCIS and invasive cancer.