需要新的方法来确定哪些导管原位癌 (DCIS) 进展为浸润性导管癌 (IDC) 的风险较高。我们回顾性研究了拒绝手术（2002-2019）并接受内分泌治疗（ET）和乳腺 MRI 的 DCIS 患者。通过递归分区分析基线 MRI 以及 3 个月和 6 个月时的变化，以对 IDC 风险进行分层。平均随访时间为 8.5 年的 62 名患者（63 名导管原位癌；1 名双侧患者）纳入其中。 51% 的人仍在接受主动监测 (AS)，但没有 IDC 证据，平均持续时间为 7.6 年。基于基线时病变清晰度和背景实质增强 (BPE) 以及 3 个月 ET 后变化的 MRI 特征的决策树将患者分为进展为 IDC 的低、中和高风险。接受 ET 治疗和接受 AS 治疗的患者的 MRI 成像特征可能有助于确定哪些 DCIS 病变处于 IDC 的低风险和高风险。© 2024。作者。

New approaches are needed to determine which ductal carcinoma in situ (DCIS) is at high risk for progression to invasive ductal carcinoma (IDC). We retrospectively studied DCIS patients who declined surgery (2002-2019), and received endocrine therapy (ET) and breast MRI. Baseline MRI and changes at 3 months and 6 months were analyzed by recursive partitioning to stratify IDC risk. Sixty-two patients (63 DCIS; 1 bilateral) with a mean follow-up of 8.5 years were included. Fifty-one percent remained on active surveillance (AS) without evidence of IDC, with a mean duration of 7.6 years. A decision tree based on MRI features of lesion distinctness and background parenchymal enhancement (BPE) at baseline and change after 3 months of ET stratified patients into low, intermediate, and high risk for progression to IDC. MRI imaging features in patients treated with ET and undergoing AS, may help determine which DCIS lesions are at low versus high risk for IDC.© 2024. The Author(s).