Can MRI detect ductal carcinoma in situ?
In population screening, ductal carcinoma in situ (DCIS) is found in up to 20% of patients [40]. There is debate as to whether it is clinically useful to detect DCIS as arguably only high grade DCIS will become invasive disease within the next 20 years. High grade DCIS is more likely to become high grade invasive disease and similarly low grade DCIS will become low grade cancer [41–43]. If disease is widespread then current optimum treatment is a mastectomy and some surgeons argue that this mutilating surgery is inappropriate in a condition that will not prove to be life threatening. The problem at present is that we cannot predict which DCIS will become potentially life threatening although this is likely to change with additional information from molecular markers. It would seem important to detect high grade DCIS particularly as two-thirds of invasive cancers are grade 3 disease. If we accept that it is important to detect early disease and DCIS is the earliest marker then can MRI f
