{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:49:21Z","timestamp":1785498561224,"version":"3.56.0"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T00:00:00Z","timestamp":1745107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The use of dynamic magnetic resonance imaging (MRI) for the evaluation, detection, and characterization of ductal carcinoma in situ (DCIS) has been increasing; however, its application in this context remains controversial and uncertain. Materials: A retrospective study including women with pure DCIS, confirmed between January 2012 and December 2022 using ultrasound-guided core-needle biopsy (CNB) or stereotaxy-guided vacuum-assisted biopsy (VAB), was conducted. Mammography, ultrasound (US), and MRI of DCIS lesions were evaluated according to histological grade. The size of the DCIS, as assessed by mammography, US, MRI, and final surgical histopathology, was compared using Lin\u2019s concordance correlation and Bland\u2013Altman plots. Results: A total of 144 women (mean age 55.5 \u00b1 10.3 years) with histopathological diagnoses of pure DCIS and no evidence of infiltration in the percutaneous biopsy were included in the study. Microcalcifications were the most prevalent feature observed in mammography (82.63%). Round\/punctate morphology was more common in low-grade lesions, while fine pleomorphic morphology was more frequent in medium- and high-grade lesions. Lesions manifesting as microcalcifications only on mammography were significantly associated with intermediate and high-nuclear grade DCIS (p = 0.005). The most common MRI manifestation of DCIS was non-mass enhancement (86.11%). A total of 141 lesions showed enhancement with MRI (sensibility 97.92%). There were no significant differences (p = 0.29) between negative and positive enhancement with MRI and the histological grade of the lesions. There were no significant differences (p = 0.49) between the type of enhancement curve with MRI and the histological grade. Preoperative MRI detected additional malignancies (multifocal, multicentric, or bilateral) in 35 patients (24.31%). Conclusions: DCIS demonstrated enhancement with MRI regardless of histological grade but overestimated the size of the lesions in low-nuclear-grade DCIS. Preoperative MRI identified additional malignancies (multifocal, multicentric, and bilateral lesions) in 24 patients (16.67%), which were confirmed by histopathological examination. These malignancies were either undetected or not visible with mammography and ultrasound. However, MRI also overestimated the size of the DCIS, leading to three unnecessary mastectomies in our study.<\/jats:p>","DOI":"10.3390\/jcm14082842","type":"journal-article","created":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T20:24:16Z","timestamp":1745180656000},"page":"2842","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Role of MRI in the Diagnosis of Ductal Carcinoma In Situ: A Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3140-4265","authenticated-orcid":false,"given":"Cristina","family":"Garc\u00eda Ruiz","sequence":"first","affiliation":[{"name":"Diagnostic Radiology Attending, Department of Radiology, Torrec\u00e1rdenas University, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1250-0841","authenticated-orcid":false,"given":"Laila Zitan","family":"Saidi","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Attending, Department of Radiology, Poniente University Hospital, 04700 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Zambrana Aguilar","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Attending, Department of Radiology, Torrec\u00e1rdenas University, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8231-2558","authenticated-orcid":false,"given":"Maricela","family":"Moreira Cabrera","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Attending, Department of Radiology, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Carvia Ponsaille","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Attending, Department of Radiology, Torrec\u00e1rdenas University, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"V\u00e1zquez Sousa","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Attending, Department of Radiology, Torrec\u00e1rdenas University, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Mart\u00ednez Porras","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Attending, Department of Radiology, Torrec\u00e1rdenas University, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2436-3856","authenticated-orcid":false,"given":"Antonio Fernando","family":"Murillo-Cancho","sequence":"additional","affiliation":[{"name":"Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almer\u00eda, 04120 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1148\/radiol.2020191535","article-title":"Surgical Outcomes for Ductal Carcinoma in Situ: Impact of Preoperative MRI","volume":"295","author":"Yoon","year":"2020","journal-title":"Radiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1148\/radiol.211425","article-title":"US, Mammography, and Histopathologic Evaluation to Identify Low Nuclear Grade Ductal Carcinoma in Situ","volume":"303","author":"Lee","year":"2022","journal-title":"Radiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1148\/rg.305095073","article-title":"Radiologic-pathologic correlation of ductal carcinoma in situ","volume":"30","author":"Yamada","year":"2010","journal-title":"Radiographics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.ejrad.2017.09.014","article-title":"Is breast magnetic resonance imaging (MRI) useful for diagnosis of additional sites of disease in patients recently diagnosed with pure ductal carcinoma in situ (DCIS)?","volume":"96","author":"Benveniste","year":"2017","journal-title":"Eur. J. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1002\/jmri.26985","article-title":"Role of Breast MRI in the Evaluation and Detection of DCIS: Opportunities and Challenges","volume":"52","author":"Greenwood","year":"2020","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1148\/radiol.211839","article-title":"Ductal Carcinoma in Situ: State-of-the-Art Review","volume":"302","author":"Grimm","year":"2022","journal-title":"Radiology."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1053\/j.ro.2018.08.006","article-title":"Advances in Breast MRI in the setting of Ductal Carcinoma in situ","volume":"53","author":"Amornsiripanitch","year":"2018","journal-title":"Semin. Roetgenol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1177\/0284185117698860","article-title":"Comparison of mammography, ultrasound, and MRI in size assessment of ductal carcinoma in situ with histopathologic correlation","volume":"58","author":"Baek","year":"2017","journal-title":"Acta Radiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1245\/s10434-012-2771-y","article-title":"Effect of MRI on the management of ductal carcinoma in situ of the breast","volume":"20","author":"Pilewskie","year":"2013","journal-title":"Ann. Surg. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1093\/jbi\/wbz039","article-title":"Ductal Carcinoma in Situ: Current Concepts in Biology, Imaging, and Treatment","volume":"1","author":"Shehata","year":"2019","journal-title":"J. Breast Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/s10549-013-2598-7","article-title":"Clinicopathologic, mammographic, and sonographic features in 1,187 patients with pure ductal carcinoma in situ of the breast by estrogen receptor status","volume":"139","author":"Rauch","year":"2013","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_12","unstructured":"D\u2019Orsi, C.J., Sickles, E.A., Mendelson, E.B., and Morris, E.A. (2013). American College of Radiology (ACR) Breast Imaging Reporting and Data System Atlas (BI-RADS Atlas), American College of Radiology. [5th ed.]. Available online: https:\/\/www.acr.org\/Clinical-Resources\/Reporting-and-Data-Systems\/Bi-Rads."},{"key":"ref_13","unstructured":"Sociedad Espa\u00f1ola de Oncolog\u00eda M\u00e9dica [Internet] (2022, March 14). Espa\u00f1a. Sociedad Espa\u00f1ola de Oncolog\u00eda M\u00e9dica. Available online: https:\/\/seom.org\/notas-prensa\/209551-dia-mundial-cancer-de-mama-la-incidencia-de-cancer-de-mama-en-espana-aumenta-y-supone-el-28-9-del-total-de-canceres-en-las-mujeres-y-desciende-la-mortalidad."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1177\/02841851231225807","article-title":"Could breast multiparametric MRI discriminate between pure ductal carcinoma in situ and microinvasive carcinoma?","volume":"65","author":"Rizzo","year":"2024","journal-title":"Acta Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1200\/JCO.18.00595","article-title":"Preoperative breast magnetic resonance imaging in women with local ductal carcinoma in situ to optimize surgical outcomes: Results from the Randomized Phase III Trial IRCIS","volume":"37","author":"Balleyguier","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1148\/radiol.2017161449","article-title":"Impact of preoperative breast MR imaging and MR-guided surgery on diagnosis and surgical outcome of women with invasive breast cancer with and without DCIS component","volume":"284","author":"Kuhl","year":"2017","journal-title":"Radiology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/jso.24616","article-title":"Clinical accuracy of preoperative breast MRI for breast cancer","volume":"115","author":"Tseng","year":"2017","journal-title":"J. Surg. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1590\/0100-3984.2018.0058","article-title":"Magnetic resonance imaging of the breast: Role in the evaluation of ductal carcinoma in situ","volume":"52","author":"Tajima","year":"2019","journal-title":"Radiol. Bras."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Nadrljanski MM, Markovi\u0107 BB, Milo\u0161evi\u0107 Z\u010c (2013). Breast ductal carcinoma in situ: Morphologic and kinetic MRI findings. Iran. J. Radiol., 10, 99\u2013102.","DOI":"10.5812\/iranjradiol.4876"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/S0140-6736(09)62070-5","article-title":"Comparative effectiveness of MRI in breast cancer (COMICE) trial: A randomized controlled trial","volume":"375","author":"Turnbull","year":"2010","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1001\/jamaoncol.2018.6269","article-title":"Association of magnetic resonance imaging and a 12-gene expression assay with breast ductal carcinoma in situ treatment","volume":"5","author":"Lehman","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.acra.2019.05.013","article-title":"The impact of preoperative breast mri on surgical management of women with newly diagnosed ductal carcinoma in situ","volume":"27","author":"Lam","year":"2020","journal-title":"Acad. Radiol."},{"key":"ref_23","first-page":"261","article-title":"Diagnostic accuracy of MRI in predicting breast tumor size: Comparative analysis of MRI vs histopathological assessed breast tumor size","volume":"79","author":"Jethava","year":"2015","journal-title":"Conn. Med."},{"key":"ref_24","first-page":"499","article-title":"Preoperative breast MR imaging: Its role in surgical planning","volume":"86","author":"Barrett","year":"2015","journal-title":"Radiol. Technol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3270","DOI":"10.1245\/s10434-012-2548-3","article-title":"Use of MRI in preoperative planning for women with newly diagnosed DCIS: Risk or benefit?","volume":"19","author":"Davis","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1002\/bjs.9797","article-title":"Meta-analysis of the effect of preoperative breast MRI on the surgical management of ductal carcinoma in situ","volume":"102","author":"Fancellu","year":"2015","journal-title":"Br. J. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3816\/CBC.2011.n.006","article-title":"The impact of preoperative magnetic resonance imaging on surgical treatment and outcomes for ductal carcinoma in situ","volume":"11","author":"Itakura","year":"2011","journal-title":"Clin. Breast Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1524-4741.2011.01204.x","article-title":"Preoperative breast MRI in the surgical treatment of ductal carcinoma in situ","volume":"18","author":"Kropcho","year":"2012","journal-title":"Breast J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1245\/s10434-013-3424-5","article-title":"Perioperative breast MRI is not associated with lower locoregional recurrence rates in DCIS patients treated with or without radiation","volume":"21","author":"Pilewskie","year":"2014","journal-title":"Ann. Surg. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"923","DOI":"10.2214\/AJR.16.17038","article-title":"Preoperative Breast MRI: Surgeons\u2019 Patient Selection Patterns and Potential Bias in Outcomes Analyses","volume":"208","author":"Lee","year":"2017","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_31","first-page":"805","article-title":"Performance evaluation of breast cancer diagnosis with mammography, ultrasonography and magnetic resonance imaging","volume":"26","author":"Sun","year":"2018","journal-title":"J. X-Ray Sci. Technol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1148\/radiol.2461061298","article-title":"Meta-analysis of MR imaging in the diagnosis of breast lesions","volume":"246","author":"Peters","year":"2008","journal-title":"Radiology"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/8\/2842\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:18:21Z","timestamp":1760030301000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/8\/2842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,20]]},"references-count":32,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["jcm14082842"],"URL":"https:\/\/doi.org\/10.3390\/jcm14082842","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,20]]}}}