# Multimodal Imaging of Ductal Carcinoma In Situ: A Single-Center Study of 75 Cases

## TL;DR

This study examines how different imaging techniques help detect breast cancer precursors called DCIS, emphasizing the role of MRI in non-calcified cases and the need for combined diagnostic approaches.

## Contribution

The study provides new insights into multimodal imaging features of DCIS and highlights MRI's role in non-calcified cases with specific kinetic patterns.

## Key findings

- Mammography detected microcalcifications in 53.8% of DCIS cases, while 46.2% lacked calcifications.
- MRI showed non-mass enhancement with persistent kinetics in 69.2% of cases, suggesting a typical DCIS pattern.
- MRI tended to overestimate lesion size compared to histopathology, with moderate correlation (r = 0.62).

## Abstract

Introduction: Ductal carcinoma in situ (DCIS) is a non-invasive precursor of breast cancer, usually detected on mammography as clustered microcalcifications. Many cases, however, lack calcifications and require complementary imaging. This study aimed to describe the multimodal imaging features of DCIS and evaluate the radiology–pathology correlation. Methods: We retrospectively reviewed 75 women (aged 36–52 years) with biopsy-proven DCIS (January 2023–June 2025). All underwent mammography, targeted ultrasound, and dynamic contrast-enhanced 1.5T MRI. Imaging findings were correlated with histopathology, and logistic regression was used to explore predictors of MRI kinetics. Results: Mammography detected microcalcifications in 53.8% of patients, while 46.2% showed no calcifications. Ultrasound frequently revealed non-mass, duct-oriented hypoechoic abnormalities in non-calcified cases. MRI consistently demonstrated non-mass enhancement, with weak or persistent kinetics without washout in 69.2% and washout in 30.8%. A moderate correlation between MRI and histological extent was found (r = 0.62, p < 0.001), with MRI tending to overestimate lesion size. Oral contraceptive use was common (61.5%) but not significantly associated with kinetic pattern or grade. Conclusions: Mammography remains essential for calcified DCIS, whereas MRI enhances detection of non-calcified lesions. Persistent kinetics without washout may represent a typical imaging feature of DCIS. However, moderate radiology–pathology concordance and frequent overestimation highlight the need for careful interpretation. These findings support a multimodal diagnostic approach that can improve detection accuracy and assist in more tailored surgical planning.