S Joukainen1, A Masarwah2, M Könönen2, M Husso2, A Sutela2, V Kärjä3, R Vanninen2,4,5, M Sudah2. 1. Department of Surgery, Division of Plastic Surgery, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland. sarianna.joukainen@kuh.fi. 2. Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland. 3. Department of Pathology, Diagnostic Imaging Centre, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland. 4. Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland. 5. Cancer Center of Eastern Finland, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
Abstract
OBJECTIVES: To prospectively determine the feasibility of preoperative supine breast MRI in breast cancer patients scheduled for oncoplastic breast-conserving surgery. METHODS: In addition to a diagnostic prone breast MRI, a supplementary supine MRI was performed with the patient in the surgical position including skin markers. Tumours' locations were ink-marked on the skin according to findings obtained from supine MRI. Changes in tumours' largest diameter and locations between prone and supine MRI were measured and compared to histology. Nipple-to-tumour and tumour-to-chest wall distances were also measured. Tumours and suspicious areas were surgically removed according to skin ink-markings. The differences between MRI measurements with reference to histopathology were evaluated with the paired-sample t test. RESULTS: Fourteen consecutive patients, 15 breasts and 27 lesions were analysed. Compared to histology, prone MRI overestimated tumour size by 47.1% (p = 0.01) and supine MRI by 14.5% (p = 0.259). In supine MRI, lesions' mean diameters and areas were smaller compared to prone MRI (- 20.9%, p = 0.009 and - 38.3%, p = 0.016, respectively). This difference in diameter was more pronounced in non-mass lesions (- 31.2%, p = 0.031) compared to mass lesions (- 9.2%, p = 0.009). Tumours' mean distance from chest wall diminished by 69.4% (p < 0.001) and from nipple by 18.2% (p < 0.001). Free microscopic margins were achieved in first operation in all patients. CONCLUSIONS: Supine MRI in the surgical position is feasible and useful in the precise localisation of prone MRI-detected lesions and provides a helpful tool to implement in surgery. Supine MRI more accurately determines tumours' size and location and might have an important role to diminish overestimations. KEY POINTS: • Breath-hold supine breast MRI is feasible using commercially available coils and sequences. • Size and area of lesions on MRI were consistently smaller when measured from the supine position as compared to the prone position. • Supine breast MRI is useful in the precise preoperative localisation of prone MRI-detected lesions. •.
OBJECTIVES: To prospectively determine the feasibility of preoperative supine breast MRI in breast cancerpatients scheduled for oncoplastic breast-conserving surgery. METHODS: In addition to a diagnostic prone breast MRI, a supplementary supine MRI was performed with the patient in the surgical position including skin markers. Tumours' locations were ink-marked on the skin according to findings obtained from supine MRI. Changes in tumours' largest diameter and locations between prone and supine MRI were measured and compared to histology. Nipple-to-tumour and tumour-to-chest wall distances were also measured. Tumours and suspicious areas were surgically removed according to skin ink-markings. The differences between MRI measurements with reference to histopathology were evaluated with the paired-sample t test. RESULTS: Fourteen consecutive patients, 15 breasts and 27 lesions were analysed. Compared to histology, prone MRI overestimated tumour size by 47.1% (p = 0.01) and supine MRI by 14.5% (p = 0.259). In supine MRI, lesions' mean diameters and areas were smaller compared to prone MRI (- 20.9%, p = 0.009 and - 38.3%, p = 0.016, respectively). This difference in diameter was more pronounced in non-mass lesions (- 31.2%, p = 0.031) compared to mass lesions (- 9.2%, p = 0.009). Tumours' mean distance from chest wall diminished by 69.4% (p < 0.001) and from nipple by 18.2% (p < 0.001). Free microscopic margins were achieved in first operation in all patients. CONCLUSIONS: Supine MRI in the surgical position is feasible and useful in the precise localisation of prone MRI-detected lesions and provides a helpful tool to implement in surgery. Supine MRI more accurately determines tumours' size and location and might have an important role to diminish overestimations. KEY POINTS: • Breath-hold supine breast MRI is feasible using commercially available coils and sequences. • Size and area of lesions on MRI were consistently smaller when measured from the supine position as compared to the prone position. • Supine breast MRI is useful in the precise preoperative localisation of prone MRI-detected lesions. •.
Entities:
Keywords:
Breast neoplasms/diagnosis; Breast/neoplasms/surgery; Humans; Magnetic resonance imaging/methods
Authors: Peter Siegler; Claire M B Holloway; Petrina Causer; Gilbert Thevathasan; Donald B Plewes Journal: J Magn Reson Imaging Date: 2011-09-16 Impact factor: 4.813
Authors: Saskia Litière; Gustavo Werutsky; Ian S Fentiman; Emiel Rutgers; Marie-Rose Christiaens; Erik Van Limbergen; Margreet H A Baaijens; Jan Bogaerts; Harry Bartelink Journal: Lancet Oncol Date: 2012-02-27 Impact factor: 41.316
Authors: Mehran Ebrahimi; Peter Siegler; Amen Modhafar; Claire M B Holloway; Donald B Plewes; Anne L Martel Journal: Phys Med Biol Date: 2014-03-10 Impact factor: 3.609
Authors: Lindsay Turnbull; Sarah Brown; Ian Harvey; Catherine Olivier; Phil Drew; Vicky Napp; Andrew Hanby; Julia Brown Journal: Lancet Date: 2010-02-13 Impact factor: 79.321
Authors: Laura J Esserman; Anjali S Kumar; Alex F Herrera; Jessica Leung; Alfred Au; Yunn-Yi Chen; Dan H Moore; Daniel F Chen; Jennifer Hellawell; Dulcy Wolverton; E Shelley Hwang; Nola M Hylton Journal: J Clin Oncol Date: 2006-10-01 Impact factor: 44.544
Authors: Francesco Sardanelli; Carla Boetes; Bettina Borisch; Thomas Decker; Massimo Federico; Fiona J Gilbert; Thomas Helbich; Sylvia H Heywang-Köbrunner; Werner A Kaiser; Michael J Kerin; Robert E Mansel; Lorenza Marotti; Laura Martincich; Louis Mauriac; Hanne Meijers-Heijboer; Roberto Orecchia; Pietro Panizza; Antonio Ponti; Arnie D Purushotham; Peter Regitnig; Marco Rosselli Del Turco; Fabienne Thibault; Robin Wilson Journal: Eur J Cancer Date: 2010-03-19 Impact factor: 9.162
Authors: Arjan P Schouten van der Velden; Margrethe S Schlooz-Vries; Carla Boetes; Theo Wobbes Journal: Am J Surg Date: 2009-04-17 Impact factor: 2.565