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Objectives To study the management of patients with ductal carcinoma in situ (DCIS) and detect the predictors of recurrence and of missing an invasive component in the preoperative biopsy, aiming at guiding tailored treatment of these cases. Materials and methods A total of 123 cases of DCIS, pure/with invasion, were retrieved from the database of a tertiary cancer hospital in the period from February 2007 to February 2018. Clinical, radiologic & pathologic characteristics and its impact on the surgical management were analyzed. Results The mean age of the patients was 50.5 ± 12.4 years. The commonest presentation was a palpable mass in 82.9% of the cases. Conservative breast surgery was successfully performed in 15 cases and mastectomy in 108 cases. Recurrence was reported in 11 cases. The underestimation rate in core needle biopsy was 48.9% missing invasive component within diagnosed malignant lesions and 19.6% missing the diagnosis of malignancy. On the other hand, overtreatment was noted as regard surgical procedure and adjuvant therapies. Conclusions Mastectomy still the most common surgical treatment of DCIS and unfortunately sentinel lymph node biopsy is still underused. Underestimation of invasive component can occur in at least 1/4 of the patients, complexing the treatment plan. Overtreatment with axillary surgery, chemotherapy or radiotherapy needs governance.

To evaluate role of fused 3-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) and 3-dimensional constructive interference in steady state (3D-CISS) in neurovascular compression in trigeminal neuralgia (TN) and hemifacial spasm (HFS).A prospective study was conducted on 30 patients (mean age 47.20 ± 11.69 years), 17 (56.7%) male and 13 (43.3%) female, with TN and HFS. 3D-TOF-MRA and 3D-CISS sequences of the cerebellopontine angle were performed, as well as postprocessing with fusion of the images. Two independent readers assessed the degree of neurovascular conflict. The images were evaluated for site, signal, and degree of nerve compression and the offending vessel. The kappa test for interobserver agreement was done.The interobserver agreement of both readers was excellent for degree of compression (k = 0.70, 95% confidence interval [CI] 0.49-0.92, r = 0.856, P = 0.001), excellent for the side affected (k = 1.0, 95% CI = 1.0-1.0, r = 1.000, P = 0.001), excellent for the offending vessel (k = 0.85, 95% CI = 0.66-1.0, P =0.001), and excellent for the position of the offending vessel (k = 0.685, 95% CI = 0.489-0.882, r = 0.863, P ≤ 0.001). There was no significant correlation between the degree of compression and signal intensity.Fused 3D-TOF-MRA and 3D-CISS images are a reliable, noninvasive tool for the evaluation of offending vessel and degree of affection in patients with neurovascular compression. MRA-CISS can be used for evaluation and treatment planning of neurovascular compression in TN and HFS.