Clinical value of x-ray mammography combined with MRI in distinguishing breast cancer at different stages

ZHAO Yuqiao; CHEN Yongya; ZHAO Liang

doi:10.20258/j.cnki.1006-9011.2025.03.015

Abstract：Objective To explore the value of x-ray mammography combined with MRI in the differential diagnosis of ductal carcinoma in situ(DCIS),ductal carcinoma in situ with microinvasion(DCIS-MI),and invasive ductal carcinoma(IDC).Methods 110 patients with breast cancer diagnosed by surgery and pathology were selected.All patients underwent x-ray mam-mography and MRI before pathological examination.Based on the pathological examination results,the value of x-ray mammogra-phy combined with MRI in the differential diagnosis of DCIS,DCIS-MI,and IDC was analyzed,and the consistency between x-ray mammography and MRI alone and in combination in diagnosing DCIS,DCIS-MI,and IDC.And pathological examination re-sults were analyzed.Results Pathological examination confirmed that there were 38 cases of DCIS,42 cases of DCIS-MI and 30 cases of IDC in 110 cases of breast cancer.The accuracy of x-ray mammography combined with MRI in diagnosing DCIS,DCIS-MI,and IDC was 95.45%(105/110),which was higher than 85.45%(94/110)and 87.27%(96/110)of x-ray mammogra-phy and MRI alone,with a statistically significant difference(P<0.05).There was no statistically significant difference in the ac-curacy of x-ray mammography and MRI in diagnosing DCIS,DCIS-MI,and IDC separately(P>0.05).According to the Kappa consistency test,the consistency between the results of x-ray mammography diagnosis of DCIS,DCIS-MI,and IDC and patho-logical diagnosis was general(Kappa=0.781,P<0.001).The consistency between the results of MRI(MRI)diagnosis of DCIS,DCIS-MI,and IDC and pathological diagnosis was general(Kappa=0.807,P<0.001).The consistency between the results of x-ray mammography combined with MRI in diagnosing DCIS,DCIS-MI,and IDC and pathological diagnosis was high(Kappa=0.931,P<0.001).There was no statistically significant difference in the apparent diffusion coefficient ADCmax values among the DCIS group,DCIS-MI group,and IDC group(P>0.05).The DCIS group had the highest ADCmin,followed by the DCIS-MI group,and the IDC group had the lowest,with a statistically significant difference(P<0.05).The early enhancement rate(EER)was the lowest in the DCIS group,followed by the DCIS-MI group,and the highest in the IDC group,with a statistically significant difference(P<0.05).Conclusion The combination of x-ray mammography and MRI has high value in the differen-tial diagnosis of DCIS,DCIS-MI,and IDC.