PURPOSE: To assess the value of local staging with preoperative magnetic resonance imaging (MRI) in patients with suspect breast lesions and the effect on therapeutic approach. MATERIALS AND METHODS: Two hundred and four consecutive women with suspect breast lesions on clinical examination (CE) and/or mammography (MX) and/or ultrasound (US) underwent preoperative contrast-enhanced MRI. Detection of multifocal, multicentric and bilateral breast cancer by all three imaging modalities was evaluated. Results of preoperative breast MRI were discussed with the treating surgeons. The type of therapeutic change after preoperative MRI was marked on a questionnaire (none, additional fine needle aspiration, core biopsy, open biopsy, wider excision, mastectomy) and considered 'necessary' or 'unnecessary' using final histopathological results as gold standard. RESULTS: In 170 patients, breast cancer was diagnosed. MRI detected 96% of multifocal disease and 95% of multicentric disease, whereas MX depicted 37 and 18%, and US 41 and 9% of them, respectively. All bilateral breast cancers were seen on MRI; both MX and US detected 56%. Findings of more extensive disease and unsuspected multiple breast cancer foci identified on MRI only, changed the therapeutic approach correctly in 30.6% of breast cancer patients. Nine unnecessary wider excisions and three unnecessary FNA/core biopsies were performed because MRI overestimated the number or size of malignant lesions. CONCLUSION: Preoperative breast MRI is an important adjunct to conventional imaging in the loco-regional staging of breast cancer and a useful tool in treatment planning.
PURPOSE: To assess the value of local staging with preoperative magnetic resonance imaging (MRI) in patients with suspect breast lesions and the effect on therapeutic approach. MATERIALS AND METHODS: Two hundred and four consecutive women with suspect breast lesions on clinical examination (CE) and/or mammography (MX) and/or ultrasound (US) underwent preoperative contrast-enhanced MRI. Detection of multifocal, multicentric and bilateral breast cancer by all three imaging modalities was evaluated. Results of preoperative breast MRI were discussed with the treating surgeons. The type of therapeutic change after preoperative MRI was marked on a questionnaire (none, additional fine needle aspiration, core biopsy, open biopsy, wider excision, mastectomy) and considered 'necessary' or 'unnecessary' using final histopathological results as gold standard. RESULTS: In 170 patients, breast cancer was diagnosed. MRI detected 96% of multifocal disease and 95% of multicentric disease, whereas MX depicted 37 and 18%, and US 41 and 9% of them, respectively. All bilateral breast cancers were seen on MRI; both MX and US detected 56%. Findings of more extensive disease and unsuspected multiple breast cancer foci identified on MRI only, changed the therapeutic approach correctly in 30.6% of breast cancerpatients. Nine unnecessary wider excisions and three unnecessary FNA/core biopsies were performed because MRI overestimated the number or size of malignant lesions. CONCLUSION: Preoperative breast MRI is an important adjunct to conventional imaging in the loco-regional staging of breast cancer and a useful tool in treatment planning.
Authors: Kaoru Itakura; Juan Lessing; Theadora Sakata; Amy Heinzerling; Eline Vriens; Dorota Wisner; Michael Alvarado; Laura Esserman; Cheryl Ewing; Nola Hylton; E Shelley Hwang Journal: Clin Breast Cancer Date: 2011-03 Impact factor: 3.225
Authors: Wendy B DeMartini; Laura Ichikawa; Bonnie C Yankaskas; Diana Buist; Karla Kerlikowske; Berta Geller; Tracy Onega; Robert D Rosenberg; Constance D Lehman Journal: J Am Coll Radiol Date: 2010-11 Impact factor: 5.532
Authors: Louise M Henderson; Julie Weiss; Rebecca A Hubbard; Cristina O'Donoghue; Wendy B DeMartini; Diana S M Buist; Karla Kerlikowske; Martha Goodrich; Beth Virnig; Anna N A Tosteson; Constance D Lehman; Tracy Onega Journal: Breast J Date: 2015-10-28 Impact factor: 2.431
Authors: Richard Ha; Simukayi Mutasa; Jenika Karcich; Nishant Gupta; Eduardo Pascual Van Sant; John Nemer; Mary Sun; Peter Chang; Michael Z Liu; Sachin Jambawalikar Journal: J Digit Imaging Date: 2019-04 Impact factor: 4.056