Ductal carcinoma in situ (DCIS) now accounts for well over 20% of cancers diagnosed in mammography screening programs. This article reviews the biology of DCIS and the unique kinetic and morphologic features of DCIS at MR imaging that allow reliable diagnosis of DCIS lesions, including noninvasive disease that is mammographically occult. Increased detection of DCIS lesions at MR imaging has important implications for high-risk screening programs and for staging of patients with newly diagnosed breast cancer. Future research may provide prognostic information extracted from the MR phenotype of in situ cancer.
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