Julie Wecsler1,2, Young Ju Jeong3, Akshara S Raghavendra4, Wendy J Mack5, Debasish Tripathy4, Mary W Yamashita6, Pulin A Sheth6, Linda Hovanessian Larsen6, Christy A Russell7, Heather MacDonald1,2, Stephen F Sener1,2, Julie E Lang1,2. 1. Division of Breast, Endocrine, and Soft Tissue Surgery, Department of Surgery, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California. 2. Department of Surgery, LAC + USC (LA County) Medical Center, Los Angeles, California. 3. Department of Surgery, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea. 4. Division of Cancer Medicine, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Preventive Medicine, University of Southern California, Los Angeles, California. 6. Division of Oncology Women's Imaging, Department of Radiology and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California. 7. Division of Medical Oncology, Department of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California.
Abstract
BACKGROUND: The use of preoperative magnetic resonance imaging (MRI) for newly diagnosed breast cancer remains controversial. We examined factors associated with detection of occult multicentric, multifocal, and contralateral malignant lesions only seen by MRI. METHODS: We performed a retrospective analysis of consecutive patients undergoing preoperative MRI for breast cancer. Clinicopathologic data were assessed regarding the findings of multifocality, multicentricity, and the presence of contralateral lesions. We analyzed the association of factors with these findings on MRI. RESULTS: Of 857 patients undergoing MRI, 770 patients met inclusion criteria. Mean age was 54.7 years. Biopsy-proven detection rates by MRI for multifocal, multicentric, and contralateral cancers were 6.2% (48 of 770), 1.9% (15 of 770) and 3.1% (24 of 770), respectively. African American race and heterogeneously or extremely dense mammographic density were associated with multifocal cancers on MRI. Larger lesion size and mammographic density were associated with multicentric cancers. Invasive lobular carcinoma (ILC) and progesterone receptor (PR)-positivity were associated with contralateral cancers. CONCLUSIONS: African American race, heterogeneously or extremely dense mammographic density, ILC, and PR-positivity were associated with additional biopsy-proven cancers based on MRI. These factors should be considered when assessing the clinical utility of preoperative breast MRI.
BACKGROUND: The use of preoperative magnetic resonance imaging (MRI) for newly diagnosed breast cancer remains controversial. We examined factors associated with detection of occult multicentric, multifocal, and contralateral malignant lesions only seen by MRI. METHODS: We performed a retrospective analysis of consecutive patients undergoing preoperative MRI for breast cancer. Clinicopathologic data were assessed regarding the findings of multifocality, multicentricity, and the presence of contralateral lesions. We analyzed the association of factors with these findings on MRI. RESULTS: Of 857 patients undergoing MRI, 770 patients met inclusion criteria. Mean age was 54.7 years. Biopsy-proven detection rates by MRI for multifocal, multicentric, and contralateral cancers were 6.2% (48 of 770), 1.9% (15 of 770) and 3.1% (24 of 770), respectively. African American race and heterogeneously or extremely dense mammographic density were associated with multifocal cancers on MRI. Larger lesion size and mammographic density were associated with multicentric cancers. Invasive lobular carcinoma (ILC) and progesterone receptor (PR)-positivity were associated with contralateral cancers. CONCLUSIONS: African American race, heterogeneously or extremely dense mammographic density, ILC, and PR-positivity were associated with additional biopsy-proven cancers based on MRI. These factors should be considered when assessing the clinical utility of preoperative breast MRI.
Authors: Norman F Boyd; Helen Guo; Lisa J Martin; Limei Sun; Jennifer Stone; Eve Fishell; Roberta A Jong; Greg Hislop; Anna Chiarelli; Salomon Minkin; Martin J Yaffe Journal: N Engl J Med Date: 2007-01-18 Impact factor: 91.245
Authors: Akshara Raghavendra; Julie Wecsler; Lingyun Ji; Pulin Sheth; Charite Ricker; Terry Church; Richard Sposto; Julie Lang; Stephen Sener; Linda Larsen; Debu Tripathy Journal: Breast Cancer Res Treat Date: 2018-12-12 Impact factor: 4.872
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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
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