According to the results of a study presented at the 2007 annual meeting of the American Society of Clinical Oncology, magnetic resonance imaging (MRI) is more likely than mammography to detect ductal carcinoma in situ (DCIS) of the breast, and appears to be particularly good at detecting high-grade DCIS.

The goal of cancer screening is to detect cancer at an early stage, when treatment will be most successful. For the early detection of breast cancer, the American Cancer Society recommends an annual mammogram and clinical breast exam starting at the age of 40. In addition to mammography, women at high-risk of breast cancer are advised to receive annual screening with breast magnetic resonance imaging (MRI). MRI has been reported to detect more breast cancers than mammography, but is also much more expensive and more likely to produce false-positive test results.

To compare mammography to MRI for the detection of DCIS, researchers conducted a study among almost 6,000 women who were screened with both MRI and mammography. A total of 167 cases of DCIS were diagnosed among study participants.

• MRI detected 92% of the DCIS cases and mammography detected 56% of the cases.
• The 12 cases of DCIS that were detected only by mammography tended to be low-grade (less aggressive).
• Of the cases of high-grade, roughly half were detected by both MRI and mammography, and half were detected only by MRI.

Comments: This study suggests that MRI may be better than mammography at detecting DCIS—particularly high-grade DCIS. It should be noted, however, that this study was performed at a highly-specialized center with extensive experience with MRI.

Reference: Kuhl CK, Schrading S, Wardelmann E, Braun M, Kuhn W, Schild HH. Magnetic resonance imaging versus mammography for diagnosing ductal carcinoma in situ. Proceedings of the American Society of Clinical Oncology. Chicago/ IL.  2007. Abstract # 1504.

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