Multimodality imaging analysis of breast ductal carcinoma in situ within papillomas
10.3760/cma.j.cn112149-20190911-00481
- VernacularTitle:乳头状瘤背景下乳腺导管原位癌多模态影像学特征分析
- Author:
Ying JIANG
1
;
Junjun LIU
;
Shuping ZHANG
;
Hong LU
;
Peifang LIU
Author Information
1. 天津医科大学肿瘤医院乳腺影像诊断科 国家肿瘤临床医学研究中心 天津市“肿瘤防治”重点实验室 天津市恶性肿瘤临床医学研究中心 乳腺癌防治教育部重点实验室 300060
- From:
Chinese Journal of Radiology
2020;54(8):781-786
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the mammography, ultrasound and MRI features of breast ductal carcinoma in situ within papillomas (DCIS-WP) and ductal carcinoma in situ in general (DCIS-IG), and to select the appropriate screening methods for breast cancer.Methods:A retrospective analysis of 134 patients with DCIS-WP and DCIS-IG confirmed by pathology from January 2015 to October 2018 was conducted, including 40 patients with DCIS-WP and 94 patients with DCIS-IG. Mammography, ultrasound and MRI images were analyzed based on BI-RADS criteria, to evaluate the missed diagnosis rate and accuracy rate of three imaging methods, and the consistency of preoperative puncture, intraoperative frozen section and postoperative paraffin section was also observed. Qualitative data were compared using the χ 2 test or Fisher′s exact test. Results:The X-ray missed diagnosis rate of DCIS-WP group and DCIS-IG group was 42.50%（17/40） and 5.32%（5/94）, respectively, while the diagnostic accuracy rate was 22.50%（9/40） and 77.66%（73/94） respectively. The difference between the two groups was statistically significant (χ2=28.268, 35.952, P<0.001). In DCIS-WP group and DCIS-IG group, there were 8 and 2 cases with multiple hypoechoic nodules in the lesions, the difference was statistically significant (χ2=20.819, P<0.001); the missed diagnosis rate was 0 and 24.47%（23/94）, the difference was statistically significant ( P<0.05). On MRI, there were 24 cases and 15 cases of DCIS-WP group and DCIS-IG group with the signs of catheter dilation, 21 cases and 16 cases with multiple papillomas background, 15 cases and 12 cases with sparse internal ring manifestations, 19 cases and 13 cases with different sizes, respectively. The difference between the two groups was statistically significant (χ2=26.378, 17.671, 8.524, 14.530, P<0.05). In DCIS-WP group and DCIS-IG group, 12 cases and 82 cases had the same diagnosis of preoperative puncture, intraoperative frozen pathology and postoperative paraffin pathology respectively, and the difference between the two groups was statistically significant (χ2=44.165, P<0.001). Conclusions:The features of DCIS-WP are different from those of DCIS-IG on mammography and ultrasound. DCIS-WP is likely to be missed on mammography as there is less calcification, while it is easier to be detected by ultrasound. MRI has good diagnostic efficacy for both types of DCIS and is helpful in differentiating them.
