The most sensitive investigation for DCIS (Ductal carcinoma in-situ) of breast?
A i.e. Mammography This answer is also an example of POC. You are free to believe that MRI is correct answer. But the latest (2012) book by authors of AIIMS-MAMC & PGI for Breast Imaging says this - Currently, nearly 90% of ductal carcinoma in situ (DCIS) are diagnosed while they are clinically occult because of mamographic detection of microcalcification (in 76%), soft tissue densities (11%) or both (13% cases). For diagnosis of DCIS, mammography is far superior (to MRI) because of its ability to pick up microcalcificationQ. MRI cannot detect this characterirstic findingQ. Only 40-50% of DCIS display an enhancement pattern typical of malignancy. These can be diagnosed on MRI alone. Remaining 50-60% can not be diagnosed on MR alone or not at all on MR. This question is based on some basic concepts of DCIS & breast imaging which are Earliest finding of DCIS is microcalcification. Mammography is most sensitive and MRI is least sensitive in detecting microcalcificationQ. (Another Q about the inability of MRI to detect calcification has already been asked many time and you have answered it but never tried to apply, that concept here.) Mammography is most sensitive for detecting early DCIS and therefore is the screeining modality of choice( 2. And MRI can't detect 50-60% early DC1S. However, because of discontinuous spread of DCIS through the ductal system, mammography may underestimate the extent of lesion. MRI is superior to mammography in determination of disease extent, size, infiltration, microinvasion and staging of DCIS (this all is done for invasive and relatively late DCIS). Screening with MRI is superior to mammography in detecting invasive breast cancer in younger women where the sensitivity of mammography is low due to presence of mammographically dense breast parenchymaQ. Although mammography remains more sensitive for detecting Ductal carcinoma in sits inCISP. But if you still want to believe that some latest British American research is behind this question. Then my advice is, stop reding books & go for journals as you would get many of them to contradict most of the lines written in your reference tent books. Indication for Breast MRI Lobular carcinoma which is difficult to detect and measure by conventional method because of multifocal and infiltrating growth pattern. - Staging of primary breast cancer - Occult primary tumour with malignant axillary lymphadenopathy and normal mammogram and breast USG. - Screen younger women with high familial risk of breast cancer. - Assessing the integrity of breast implant
Mammography
Ultrasoun
MRI
PET Scan