Purpose: to verify the usefulness of pre-operative MRI in newly diagnosed breast cancer patients. Methods and Materials: mammography, US, and CE-MR imaging were analyzed from 291 consecutive women with known invasive breast cancer. We calculated the MRI detection rate of additional malignant according to following parameters: histological type, tumor size, mammographic density (BI-RADS classification from 1-fat to 4-dense). The gold standard was pathologic examination. Results: MRI identified 40 mammographically and sonographically occult malignant lesions other than the index cancer in 27/291 patients(9%). These additional sites of cancer were in the same quadrant as the index cancer in 13 women(4%), in a different quadrant in 12 women(4%) and in the controlateral breast in the remaining 2 women(1%). The cancer-detection rate in the subgroup of index cancer with lobular histological type was 25 %, significantly higher (p=0.03) than the cancer-detection rate of 11 % in the subgroup of ductal histological type. The cancer-detection rate in the subgroup of index cancer greater than 2 cm was 27 %, significantly higher (p=0.001) than the cancer-detection rate of 8 % in the less than 2 cm index cancer subgroup. There was no correlation with breast radiological density (p=0.48). Conclusions: in patients with newly diagnosed breast cancer, the pre-operative MR is useful in detecting synchronous malignant lesions that are not detected on conventional breast imaging. The cancer-detection rate is 9 %. The use of pre-operative MR as an adjunct to conventional breast imaging in women with infiltrating lobular index cancer and index cancer larger than 2 cm is especially beneficial.

Multifocal, multicentric, and contralateral breast cancers: MR imaging in preoperative assessment of local extent disease

CARBOGNIN, Giovanni;BONETTI, Franco;POZZI MUCELLI, Roberto
2011-01-01

Abstract

Purpose: to verify the usefulness of pre-operative MRI in newly diagnosed breast cancer patients. Methods and Materials: mammography, US, and CE-MR imaging were analyzed from 291 consecutive women with known invasive breast cancer. We calculated the MRI detection rate of additional malignant according to following parameters: histological type, tumor size, mammographic density (BI-RADS classification from 1-fat to 4-dense). The gold standard was pathologic examination. Results: MRI identified 40 mammographically and sonographically occult malignant lesions other than the index cancer in 27/291 patients(9%). These additional sites of cancer were in the same quadrant as the index cancer in 13 women(4%), in a different quadrant in 12 women(4%) and in the controlateral breast in the remaining 2 women(1%). The cancer-detection rate in the subgroup of index cancer with lobular histological type was 25 %, significantly higher (p=0.03) than the cancer-detection rate of 11 % in the subgroup of ductal histological type. The cancer-detection rate in the subgroup of index cancer greater than 2 cm was 27 %, significantly higher (p=0.001) than the cancer-detection rate of 8 % in the less than 2 cm index cancer subgroup. There was no correlation with breast radiological density (p=0.48). Conclusions: in patients with newly diagnosed breast cancer, the pre-operative MR is useful in detecting synchronous malignant lesions that are not detected on conventional breast imaging. The cancer-detection rate is 9 %. The use of pre-operative MR as an adjunct to conventional breast imaging in women with infiltrating lobular index cancer and index cancer larger than 2 cm is especially beneficial.
2011
Breast; MR; Cost-effectiveness; Diagnostic procedure; Neoplasia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/349171
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