Contrast-enhanced breast MRI finds breast lesions missed on mammography and ultrasound, and can help surgeons plan the best surgical treatment, improving patient outcomes, according to a study by Italian researchers presented at the American Roentgen Ray Society (ARRS) annual meeting this week in San Diego.
Dr. Valeria Dominelli from the University of Rome "La Sapienza" and colleagues tracked 164 women with biopsy-proven breast cancer, analyzing how breast MRI influenced their surgical management.
Mammography plus ultrasound found 175 suspicious lesions in the cohort of women included in the study. Contrast-enhanced MRI found all of these, as well as an additional 51 suspicious lesions, which were confirmed by histology, in 34 patients (21%).
Breast MRI also changed the therapy that had been proposed (based on mammography and ultrasound imaging) for 32 out of the 164 patients:
- Seven patients with multifocal disease detected with MRI had a partial mastectomy instead of a planned lumpectomy.
- Three patients underwent mastectomy for multicentric disease.
- 12 patients with contralateral lesions had additional surgery on the contralateral breast.
- Two patients underwent neoadjuvant chemotherapy because the cancer had invaded the chest muscles, and this had been identified only by MRI.
- Four patients had a partial mastectomy because of a larger tumor size.
Dominelli's team found that contrast-enhanced MRI rated higher in sensitivity, accuracy, and positive predictive value (PPV) for malignant lesion detection and identification when compared to mammography and ultrasound together:
|
The team concluded that contrast-enhanced breast MRI helps doctors make better cancer treatment decisions, and it should be recommended for mapping tumor extent in patients with newly diagnosed breast cancer.
Breast MRI reduces local recurrence rates
In another study also presented by Dominelli, results indicate that use of preoperative breast MRI before breast cancer surgery may reduce the number of local cancer recurrences at follow-up.
This study included 49 patients with a local recurrence that had been found seven to 47 months after surgical treatment of the primary cancer. Ten patients had contrast-enhanced breast MRI before surgery, while the remaining 39 patients did not.
The team found significantly more cancers in the opposite breast and more local recurrence in patients who did not have the MRI exam prior to surgery compared to those who did: 88% and 85%, respectively, versus 12% and 14%, respectively (p < 0.001).
The findings suggest that preoperative breast MRI staging would reduce the number of local cancer recurrences at follow-up, Dominelli said.
By Kate Madden Yee
AuntMinnie.com staff writer
May 3, 2010
Related Reading
Can DBT unseat MRI for screening high-risk women? March 22, 2010
MRI finds undetected tumors in second breast of older women, March 17, 2010
Breast MRI excels at high-risk screening; mammo not needed, February 26, 2010
Breast MRI best for finding mammographically occult cancers, November 9, 2009
Breast MRI can resolve mammography findings, but use with caution, October 6, 2009
Copyright © 2010 AuntMinnie.com
