Delayed breast MRI sequences in DCIS
Research type
Research Study
Full title
A pilot study of the value of delayed dynamic breast MRI sequences in the assessment of the extent of ductal carcinoma in situ
IRAS ID
150073
Contact name
Anthony J Maxwell
Contact email
Sponsor organisation
University Hospital of South Manchester NHS Foundation Trust
Research summary
In ductal carcinoma in situ (DCIS) of the breast malignant cells grow and spread within the milk ducts. If untreated it can progress to invasive breast cancer (which can then spread beyond the breast and result in death) within a few years.
In most cases, DCIS does not cause symptoms. It is typically diagnosed on screening mammograms when it is identified as a focus of microcalcification. This shows as a cluster of white dots within the breast tissue. It accounts for 20% of the malignancies found on screening in the UK.
Treatment is with surgical removal of the disease with a margin of normal tissue. Failure to completely remove the disease leads to local recurrence, which in 50% of cases is invasive and can result in death.
Preoperative surgical planning relies primarily upon assessment of the disease extent on mammography. This may under- or over-estimate the true extent of DCIS and may result in failure to completely excise the disease, leading to a second operation to remove more tissue. The re-operation rate for women with screen-detected DCIS is 33%, higher than the 20% re-operation rate for women who have invasive breast cancer.
Previous studies have investigated the use of breast MRI in assessing DCIS, with variable results, and it is not widely used for this purpose in the UK. Recent work suggests that gadolinium-containing contrast medium (given intravenously as a routine part of the scan) enters the milk ducts. This suggests that gadolinium may accumulate in the ducts over a period of time following intravenous contrast medium injection. In this study we intend to perform scans up to one hour post-contrast medium injection in order to investigate whether this is a frequent occurrence in women with DCIS and, if so, whether it may improve the assessment of disease extent
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
14/NW/0157
Date of REC Opinion
17 Apr 2014
REC opinion
Further Information Favourable Opinion