Ductal Carcinoma in situ Diagnosedby Magnetic Resonance Imaging-Guided Breast Biopsy

Abstract

Magnetic resonance imaging (MRI) is widely recognized as an imaging method with relatively higher sensitivity than other imaging modalities for detecting breast cancer (BC), although the specificity is controversial. Wetreated a patient with BC that was detected by MRI and confirmed by examination of an MRI-guided biopsyspecimen. The tumor was not clearly identified by ultrasonography (US), mammography (MMG), or a physicalexamination. A 50-year-old female came to our hospital because a focally asymmetric density (FAD) in the leftbreast was seen on MMG. Physical and US examinations were unremarkable. However, MRI showed enhancednodules distributed segmentally in the right lower internal quadrant. An US performed 3 months later did notshow any findings in the region. Therefore, we referred the patient to a hospital that was equipped to performMRI-guided biopsy. Ultrasound-guided fine needle aspiration and core needle biopsy of the region were unable toconfirm the presence of BC, but ductal carcinoma in situ (DCIS) was seen on an MRI-guided biopsy specimen.The patient then underwent surgery at our hospital. This case taught us the importance of breast MRI andMRI-guided biopsy for lesions not demonstrated on US or MMG.