The accuracy of incremental pre-operative breast MRI findings – Concordance with histopathology in the Swedish randomized multicenter POMB trial

613 Background: To evaluate the impact of preoperative magnetic resonance imaging (MRI) of the breast on the clinical management of patients with operable breast cancer (BC). Methods: Retrospective analysis of 160 patients with operable breast cancer (stages Tis, through T4), who were treated from 2002 through 2004. All patients underwent a full mammographic assessment, high frequency breast ultrasound, and breast MRI. The impact of preoperative MRI was evaluated for each patient with regard to changes in the therapeutic procedure. Patient and tumor characteristics were analysed to identify possible patient subgroups that predominantly benefit from preoperative MRI. Results: Preoperative MRI affected the clinical management in 44 of 160 patients (27.5%). In 30 cases (18.75%) additional in-situ or invasive cancers or a more widespread tumor extent were diagnosed correctly which went undetected by clinical palpation, mammography, and breast ultrasound. In 14 cases (8.75%) additional, surgical procedures were performed based on suspicious MRI findings with benign pathology. Age, menopausal status, breast density, tumor characteristics (type, tumor size, grading), ER-, PR- and HER2- receptor features did not significantly differ between patients in which breast MRI affected the clinical management and patients that experienced no additional information from MRI. Conclusions: Preoperative breast MRI changes surgical management in a considerable amount of patients with operable breast cancer. MRI detects additional invasive carcinoma and proves to be a meaningful supplement to the conventional work-up in the clinical management of breast cancer. This benefit is independent from patients and tumor characteristics. No significant financial relationships to disclose.

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3–5 BI-RADs Microcalcifications: Correlation between MRI and Histological Findings

ISRN Oncology ◽

10.5402/2011/643890 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Valeria Fiaschetti ◽

Chiara Adriana Pistolese ◽

Tommaso Perretta ◽

Elsa Cossu ◽

Chiara Arganini ◽

...

Keyword(s):

Predictive Value ◽

Breast Imaging ◽

Breast Mri ◽

Data Systems ◽

Mri Findings ◽

Day Range ◽

Contrast Enhanced ◽

Malignant Lesions ◽

Stereotactic Vacuum Assisted Biopsy ◽

Sensitivity Specificity

Purpose. To evaluate the correlation between MRI and histopathological findings in patients with mammographically detected 3–5 BI-RAD (Breast Imaging Reporting And Data Systems) microcalcifications and to allow a better surgical planning. Materials and Method. 62 female Patients (age ) with screening detected 3–5 BI-RAD microcalcifications underwent dynamic 3 T contrast-enhanced breast MRI. After 30-day (range 24–36 days) period, 55 Patients underwent biopsy using stereotactic vacuum-assisted biopsy (VAB), 5 Patients underwent stereotactic mammographically guided biopsy, and 2 Patients underwent MRI-guided VAB. Results. Microhistology examination demonstrated 36 malignant lesions and 26 benign lesions. The analysis of MRI findings identified 8 cases of MRI BI-RADS 5, 23 cases of MRI BI-RADS 4, 11 cases of MRI BI-RADS 3, 4 cases type A and 7 cases type B, and 20 cases of MRI BI-RADS 1-2. MRI sensitivity, specificity, positive predictive value, and negative predictive value were 88.8%, 76.9%, 84.2%, and 83.3%, respectively.

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Granular cell tumour of the breast: MRI findings and review of the literature

British Journal of Radiology ◽

10.1259/bjr/95130566 ◽

2007 ◽

Vol 80 (960) ◽

pp. 970-974 ◽

Cited By ~ 28

Author(s):

A M Scaranelo ◽

K Bukhanov ◽

P Crystal ◽

A M Mulligan ◽

F P O'Malley

Keyword(s):

Breast Mri ◽

Granular Cell ◽

Cell Tumour ◽

Granular Cell Tumour ◽

Review Of The Literature ◽

Mri Findings

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Breast Magnetic Resonance Imaging of Multicentric, Multifocal and Bilateral Cancer — A Case-based Review

European Oncology & Haematology ◽

10.17925/eoh.2011.07.01.24 ◽

2011 ◽

Vol 07 (01) ◽

pp. 24

Author(s):

Virginia Pérez Dueñas ◽

María Ruíz de Gopegui Andreu ◽

Sara Morón Hodge ◽

Asunción Suárez Manrique ◽

◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

False Positive ◽

Breast Magnetic Resonance Imaging ◽

Breast Mri ◽

Resonance Imaging ◽

Mri Findings ◽

Mri Features ◽

Breast Magnetic Resonance

Multifocal or multicentric breast cancer can be difficult to detect on mammography or ultrasound, particularly in patients with dense breast tissue. A multimodality approach that includes breast magnetic resonance imaging (MRI) is indicated, particularly when conservative surgery is being considered as it is the most sensitive technique for identifying additional sites of disease. However, its influence on recurrence and survival rates has yet not been clearly established, and false-positive cases may lead to more aggressive management and treatment. Radiologists should therefore be aware of relevant breast MRI findings. Infiltrating carcinomas, contralateral unsuspected carcinomas, occult carcinomas, false-positive cases and post-chemotherapy changes. Several cases of multiple-site breast carcinomas and their corresponding mammographic, ultrasound and MRI features have been reviewed for this article, in which the definition and differences between multifocal, multicentric and contralateral breast carcinoma are explained and the most relevant imaging findings on MRI are illustrated and correlated with mammogram and ultrasound findings. Finally, the role of breast MRI in the pre-operative assessment of breast cancer is discussed.

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Preclinical breast MRI findings in inflammatory breast carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2005.23.16_suppl.899 ◽

2005 ◽

Vol 23 (16_suppl) ◽

pp. 899-899

Author(s):

F. Nakhlis ◽

M. Duggan ◽

M. Golshan ◽

E. Levin

Keyword(s):

Breast Carcinoma ◽

Breast Mri ◽

Mri Findings ◽

Inflammatory Breast Carcinoma

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Efficacy of breast MRI in elderly women

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.608 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 608-608

Author(s):

J. Yu ◽

E. Morris ◽

A. Park ◽

H. Cody ◽

M. L. Gemignani

Keyword(s):

Breast Cancer ◽

False Positive ◽

Elderly Women ◽

False Positive Rate ◽

Breast Mri ◽

Disease Assessment ◽

Mri Findings ◽

History Of ◽

Diagnosis Of Cancer ◽

Extent Of Disease

608 Background: Breast MRI is useful in evaluating extent of disease and screening of high risk patients, especially younger patients with dense breasts. The utility of MRI in the elderly population is currently unknown. The purpose of this study was to review the use of breast MRI and MRI findings in elderly women. Methods: Retrospective review identified women over the age of 70 who underwent breast MRI at our institution between 11/2000 and 12/2005. Clinicopathologic features, MRI results and mammograms (MMG) were reviewed. Results: 228 patients were identified. The mean age was 73.5 years (range 70–91). Forty-three patients (19%) had no history of breast cancer, 99 (43%) had a history of breast cancer, and 86 (38%) had a current diagnosis of breast cancer at the time of MRI. Ninety-two patients (40%) underwent MRI for screening, 49 (21%) as further workup for an abnormal MMG or physical finding, and 78 (34%) for extent of disease assessment. MRI found 49 additional sites of abnormality and 15 additional cancers (14% false positive). Five cancers were detected in women with no current diagnosis of cancer. In patients with a diagnosis of cancer at the time of MRI, 10 additional cancers were found: 7 in the contralateral breast and 3 additional ipsilateral sites. Conclusions: MRI detected an additional 15 mammographically occult breast cancers in this population of women over the age of 70. MRI was efficacious in screening as well as evaluating extent of disease, with a relatively low false-positive rate of 14%. Breast MRI is a useful tool in the evaluation of elderly patients; further study in the use of MRI for screening in this population is needed. [Table: see text] No significant financial relationships to disclose.

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Analysis of magnetic resonance imaging (MRI) in the detection of mammographically occult breast carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.603 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 603-603

Author(s):

L. Vallow ◽

S. Packianathan ◽

D. Feigel ◽

E. DePeri ◽

S. Buskirk ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Breast Mri ◽

Breast Disease ◽

Newly Diagnosed ◽

Breast Cancer Patients ◽

Mri Findings ◽

Index Lesion ◽

Cancer Management ◽

Infiltrating Ductal Carcinoma

603 Background: Breast MRI may be useful for detecting mammographically occult ipsilateral carcinoma in newly diagnosed breast cancer. Our initial experience with breast MRI, demonstrated 16% of patients to have additional breast disease detected only by preoperative MRI. We further analyzed our findings to identify an association between patient factors and MRI detected disease. Methods: Preoperative MRI scans of 390 women with newly diagnosed breast cancer were reviewed. Using only patients with pathologic verification, the incidence of mammographically occult ipsilateral cancer was determined. Patient and tumor characteristics were further analyzed to identify factors which may predict pathologically positive MRI findings. Results: Of the 390 women undergoing preoperative MRI, 120 (31%) had ipsilateral findings requiring biopsy. Pathologically verified additional ipsilateral cancer was detected in 62 (16%). Multicentric disease was detected in 32 (52%) and multifocal or more extensive local disease in 30 (48%). The median age of all patients was 62 (27% premenopausal) whereas the median age of those with MRI detected additional carcinoma was 55 (44% premenopausal). Of those with additional disease detected by MRI, 74% had index lesions =1 cm and 63% node negative. The most common histology of the index lesion was infiltrating ductal carcinoma in 64%. In the 62 patients found to have additional disease by MRI the most common histology included infiltrating ductal carcinoma (58%), ductal carcinoma-in-situ (34%) and infiltrating lobular (8%). The histology of the MRI detected additional disease was identical to the index lesion in 71%. Conclusions: In women with newly diagnosed breast cancer, there was a 16% incidence of pathologically proven, mammographically occult ipsilateral disease detected by MRI. Patients found to have additional disease tended to be younger, premenopausal or have index tumors =1cm. The contribution of preoperative MRI in breast cancer management continues to evolve. A lower threshold for obtaining breast MRI may be appropriate in selected subsets of breast cancer patients. No significant financial relationships to disclose.

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Does breast density affect the ability of MRI to detect mammographically occult cancers?

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.54 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 54-54

Author(s):

Beth Cutler Freedman ◽

Jocelyn Luongo ◽

Alyssa Gillego ◽

Tamara Fulop ◽

Susan K. Boolbol

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Breast Density ◽

Retrospective Chart Review ◽

Breast Mri ◽

Mammographic Breast Density ◽

Breast Cancer Patients ◽

Mri Findings ◽

Number Of Patients ◽

Density Methods

54 Background: In breast cancer patients, the use of preoperative MRI is increasing. A change in the operative plan due to MRI findings occurs in 8%-20% of cases. Preoperative MRI is used routinely by many surgeons and radiologists, but debate persists with regard to its indications. We evaluated whether mammographic breast density affected MRI findings. We also examined whether the number of MRI detected synchronous cancers were affected by breast density. Methods: A retrospective chart review was performed of newly diagnosed breast cancer patients who underwent preoperative MRI from 2008-2011. There were three categories of breast density: fat-replaced, scattered fibroglandular densities, and dense. We determined the number of patients in each group who underwent biopsies based on MRI findings, and evaluated the number of occult cancers diagnosed as a result of these biopsies. Results: 301 patients were included. Overall, 64 patients (21%) who underwent an image guided biopsy based on pre-operative breast MRI were diagnosed with an additional focus of cancer. Of the 17 patients with fat-replaced breasts, 4 underwent additional biopsy, and carcinoma was identified in all patients. 149 patients had scattered fibroglandular densities; 53 (36%) underwent additional biopsies. New cancers were diagnosed in 28 patients (19%). Of 135 patients with dense breasts, 61 patients (45%) had additional biopsies, and new cancers were diagnosed in 24 % of these patients. Conclusions: MRI detected additional cancer in 21% of patients in this study. MRI is sensitive and specific in patients with fat-replaced breasts (100%), but due to the small number of patients in this group, additional studies must be done to evaluate the usefulness in this group of patients. We conclude that MRI is useful for detecting additional cancers in patients of all breast densities, and may change the surgical options of the patient when multicentric or contralateral disease is diagnosed.[Table: see text]

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Application of Breast Ultrasound Elastography to Differentiate Intracapsular Collection from Silicone-Induced Granuloma of Breast Implant Capsule Complementarily to Contrast-Enhanced Breast Magnetic Resonance Imaging

Breast Cancer Basic and Clinical Research ◽

10.1177/1178223417737994 ◽

2017 ◽

Vol 11 ◽

pp. 117822341773799 ◽

Cited By ~ 3

Author(s):

Eduardo de Faria Castro Fleury ◽

Ana Claudia Gianini ◽

Veronica Ayres ◽

Luciana C Ramalho ◽

Decio Roveda ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Contrast Enhancement ◽

Breast Implant ◽

Breast Mri ◽

Breast Implants ◽

Ultrasound Elastography ◽

Resonance Imaging ◽

Mri Findings ◽

Solid Lesions

Background: To determine whether there is correlation between magnetic resonance imaging (MRI) findings and breast elastography to differentiate seroma/hematoma from silicone-induced granuloma of breast implant capsule (SIGBIC). Methods: Prospective study of 99 patients with breast implants submitted to breast MRI during the period from February 1 to May 1, 2017. Patients who present MRI findings of seroma/hematoma or SIGBIC were submitted to a complementary ultrasound elastography study to evaluate the correlation of the results. The criteria adopted for the diagnosis of granuloma by MRI were heterogeneous hypersignal in the T2-weighted sequences, late contrast enhancement, and black drop sign. Lesions that did not enhance after the use of contrast were considered as seroma/hematoma. By elastography, the results were considered positive for granuloma when presented as hard lesions, whereas seroma/hematoma presented as soft lesions. Results: Of the 99 patients evaluated, 15 were included in the study. Of the 15 patients, 9 had solid intracapsular MRI masses, whereas 6 presented collections without contrast enhancement. The complementary elastography study showed correlation with MRI results in all cases of SIGBIC and seroma/hematoma, being elastography able to differentiate lesions from solid to cystic. Conclusions: Elastography of intracapsular masses in breast implants presented results compatible with those found by MRI to differentiate solid lesions from collections.

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