Abstract
Objectives
Although magnetic resonance imaging (MRI) has a high sensitivity in the detection
of tumours, there is still much discussion about its role in breast cancer detection.
MRI is not yet routinely used to further characterize lesions in patients diagnosed
with breast cancer. This study investigated the impact of preoperative MRI on the
surgical treatment of women with biopsy proven breast cancer. The diagnostic value
of preoperative MRI was compared with that of conventional imaging (mammography and
ultrasonography), and the diffusion-weighted imaging technique was also evaluated.
Study design
40 women underwent conventional imaging and biopsy as part of the clinical workup.
In addition, preoperative MRI was performed in each patient. The kinetics of contrast
captation were monitored and apparent diffusion coefficients were calculated. All
imaging findings were compared with the histopathologic results, which were used as
the gold standard. Differences in tumour extent, as determined by ultrasonography,
MRI and histopathology, were evaluated.
Results
Contrast captation kinetics curves are mostly aspecific, while apparent diffusion
coefficient values seem to correlate much better with tumour malignancy. MRI correlated
more accurately with histopathological findings than ultrasonography and even revealed
unsuspected multifocal and multicentric breast carcinoma in 20 patients (50%). The
surgical plan of seven patients (18%) was changed as a result of the additional information
provided by MRI.
Conclusion
Diffusion-weighted imaging as a complementary tool to contrast captation kinetics
and morphologic measurements may increase the specificity of MRI and help in differentiating
between benign and malignant breast lesions. In addition, MRI yields more precise
information than mammography and ultrasonography about the exact location, the extent,
the multifocality or multicentricity of the tumour and can also detect possible additional
tumours. Although MRI will never replace mammography (screening) or ultrasonography
as a test for breast cancer in women with no high risk (e.g. BRCA 1 or 2 carriers),
its use in a preoperative setting may allow more accurate staging of the disease,
which in turn could result in a change in the treatment planning.
Key words
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Article info
Publication history
Published online: November 12, 2012
Accepted:
October 24,
2012
Received in revised form:
September 5,
2012
Received:
April 10,
2012
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
