MRI before reexcision surgery in patients with breast cancer.

MRI before reexcision surgery in patients with breast cancer. Research Abstract Details 

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MRI before reexcision surgery in patients with breast cancer. Abstract Text:

Janie M Lee,Susan G Orel,Brian J Czerniecki,Lawrence J Solin,Mitchell D Schnall,

OBJECTIVE: The aims of this study were to assess the diagnostic accuracy of MRI in evaluating patients for residual cancer, identify the prevalence of multicentric or multifocal disease, and evaluate the impact of MRI on surgical treatment planning. SUBJECTS AND METHODS. Of 101 potentially eligible patients, 80 candidates for breast conservation therapy who had primary breast cancer in 82 breasts diagnosed by excisional biopsy with close or positive margins were included in the study group. All patients underwent contrast-enhanced MRI before further surgery and subsequently underwent either reexcision lumpectomy or mastectomy with histopathologic correlation. RESULTS: Residual carcinoma, either invasive or in situ, was present in 59.8% of the breasts. The sensitivity and specificity of MRI for detecting residual disease were 61.2% and 69.7%, respectively. Twenty-three additional lesions distant from the biopsy site were identified in 19 breasts, and 18 suspicious lesions underwent biopsy. Histology results indicated that six lesions were malignant, so the overall prevalence was 7.3%. The positive predictive value of identifying an additional suspicious lesion was 33.3%. In 24 breasts, MRI changed which procedure would be performed next from reexcision lumpectomy to mastectomy (n = 9), biopsy of an additional lesion in the ipsilateral (n = 12) or contralateral (n = 2) breast, or neoadjuvant chemotherapy (n = 1). Approximately 25% of the breasts underwent mastectomy as definitive surgical treatment. CONCLUSION: Overlap in the appearances of benign and malignant lesions limits MRI evaluation for residual disease. MRI can show additional suspicious lesions that are likely to be multicentric or multifocal disease. These findings changed the original treatment plan for approximately 30% of breasts.

MRI before reexcision surgery in patients with breast cancer. Publishing Authors By Initials

JM Lee,SG Orel,BJ Czerniecki,LJ Solin,MD Schnall,

For similar investigative techniques: epidemiologic methods: statistics as topic: sensitivity and specificity research abstracts see: investigative techniques: epidemiologic methods: statistics as topic: sensitivity and specificity research

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MRI before reexcision surgery in patients with breast cancer. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: AJR. American journal of roentgenology

VOLUME: 182

Page Numbers: 473-80

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ISSN: 0361-803X

DAY: 15

MONTH: Feb

YEAR: 2004

MRI before reexcision surgery in patients with breast cancer. Information

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LANGUAGE: eng

NlmUniqueID: 7708173

MRI before reexcision surgery in patients with breast cancer. Keywords Mesh Terms:

KEYWORDS: Sensitivity and Specificity

MESH TERMS: pathology

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Grant and Affiliation Information for MRI before reexcision surgery in patients with breast cancer.

AFFILIATION: Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA. jlee45@partners.org

Country: United States

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MEDLINETA: AJR Am J Roentgenol

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