Magnetic resonance imaging insights from active surveillance of women with ductal carcinoma in situ

New approaches are needed to determine which ductal carcinoma in situ (DCIS) is at high risk for progression to invasive ductal carcinoma (IDC). We retrospectively studied DCIS patients who declined surgery (2002–2019), and received endocrine therapy (ET) and breast MRI. Baseline MRI and changes at...

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Bibliographic Details
Published in:NPJ breast cancer 2024-08, Vol.10 (1), p.71-9, Article 71
Main Authors: Greenwood, Heather I., Maldonado Rodas, Cristian K., Freimanis, Rita I., Glencer, Alexa C., Miller, Phoebe N., Mukhtar, Rita A., Brabham, Case, Yau, Christina, Rosenbluth, Jennifer M., Hirst, Gillian L., Campbell, Michael J., Borowsky, Alexander, Hylton, Nola, Esserman, Laura J., Basu, Amrita
Format: Article
Language:English
Subjects:
692/53/2422
692/699/67/1347
Biomedical and Life Sciences
Biomedicine
Breast cancer
Cancer Research
Cell Biology
Human Genetics
Magnetic resonance imaging
Oncology
Surveillance
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Summary:New approaches are needed to determine which ductal carcinoma in situ (DCIS) is at high risk for progression to invasive ductal carcinoma (IDC). We retrospectively studied DCIS patients who declined surgery (2002–2019), and received endocrine therapy (ET) and breast MRI. Baseline MRI and changes at 3 months and 6 months were analyzed by recursive partitioning to stratify IDC risk. Sixty-two patients (63 DCIS; 1 bilateral) with a mean follow-up of 8.5 years were included. Fifty-one percent remained on active surveillance (AS) without evidence of IDC, with a mean duration of 7.6 years. A decision tree based on MRI features of lesion distinctness and background parenchymal enhancement (BPE) at baseline and change after 3 months of ET stratified patients into low, intermediate, and high risk for progression to IDC. MRI imaging features in patients treated with ET and undergoing AS, may help determine which DCIS lesions are at low versus high risk for IDC.
ISSN:2374-4677
2374-4677
DOI:10.1038/s41523-024-00677-9