nach oben

Erschienen in:

01.09.2008 | Clinical Trial

Influence of preoperative MRI on the surgical management of patients with operable breast cancer

verfasst von: Michael Braun, Martin Pölcher, Simone Schrading, Oliver Zivanovic, Theresa Kowalski, Uta Flucke, Claudia Leutner, Tong-Wong Park-Simon, Christian Rudlowski, Walther Kuhn, Christiane K. Kuhl

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 1/2008

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Evaluation of 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), 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 analyzed to identify possible patient subgroups that predominantly would 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 that turned out to be benign in final 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 of patients with operable breast cancer. MRI detects additional invasive carcinoma and proves to be a powerful supplement to the conventional work-up in the clinical management of breast cancer. This advantage is independent from patients- and tumor-specific characteristics.

Holland R et al (1985) Histologic multifocality of Tis, T1-2 breast carcinomas. Implications for clinical trials of breast-conserving surgery. Cancer 56(5):979–990PubMedCrossRef

Wapnir IL et al (2006) Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in five National Surgical Adjuvant Breast and Bowel Project node-positive adjuvant breast cancer trials. J Clin Oncol 24(13):2028–2037PubMedCrossRef

Vicini FA et al (2003) Does local recurrence affect the rate of distant metastases and survival in patients with early-stage breast carcinoma treated with breast-conserving therapy? Cancer 97(4):910–919PubMedCrossRef

Slanetz PJ et al (2002) Occult contralateral breast carcinoma incidentally detected by breast magnetic resonance imaging. Breast J 8(3):145–148PubMedCrossRef

Liberman L et al (2003) MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. Am J Roentgenol 180(4):901–910

Orel SG et al (1995) Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. Radiology 196(1):115–122PubMed

Fischer U, Kopka L, Grabbe E (1999) Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology 213(3):881–888PubMed

Bedrosian I et al (2003) Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer 98(3):468–473PubMedCrossRef

Tillman GF et al (2002) Effect of breast magnetic resonance imaging on the clinical management of women with early-stage breast carcinoma. J Clin Oncol 20(16):3413–3423PubMedCrossRef

10.

Hata T et al (2004) Magnetic resonance imaging for preoperative evaluation of breast cancer: a comparative study with mammography and ultrasonography. J Am Coll Surg 198(2):190–197PubMedCrossRef

11.

Morakkabati-Spitz N et al (2005) Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI. Eur Radiol 15(9):2010–2017PubMedCrossRef

12.

Menell JH et al (2005) Determination of the presence and extent of pure ductal carcinoma in situ by mammography and magnetic resonance imaging. Breast J 11(6):382–390PubMedCrossRef

13.

Esserman L et al (1999) Contrast-enhanced magnetic resonance imaging to assess tumor histopathology and angiogenesis in breast carcinoma. Breast J 5(1):13–21PubMedCrossRef

14.

Liberman L et al (2003) MR imaging findings in the contralateral breast of women with recently diagnosed breast cancer. Am J Roentgenol 180(2):333–341

15.

Bluemke DA et al (2004) Magnetic resonance imaging of the breast prior to biopsy. JAMA 292(22):2735–2742PubMedCrossRef

16.

Fabre Demard N et al (2005) Breast MRI in invasive lobular carcinoma: diagnosis and staging. J Radiol 86(9 Pt 1):1027–1034PubMedCrossRef

17.

Weinstein SP et al (2001) MR imaging of the breast in patients with invasive lobular carcinoma. Am J Roentgenol 176(2):399–406

18.

Schelling M et al (1997) Optimized differential diagnosis of breast lesions by combined B-mode and color Doppler sonography. Ultrasound Obstet Gynecol 10(1):48–53PubMedCrossRef

19.

Eberl MM et al (2006) BI-RADS classification for management of abnormal mammograms. J Am Board Fam Med 19(2):161–164PubMedCrossRef

20.

Kuhl CK et al (1997) Interventional breast MR imaging: clinical use of a stereotactic localization and biopsy device. Radiology 204(3):667–675PubMed

21.

Kuhl CK et al (2001) MR imaging-guided large-core (14-gauge) needle biopsy of small lesions visible at breast MR imaging alone. Radiology 220(1):31–39PubMed

22.

Remmele W, Stegner HE (1987) Recommendation for uniform definition of an immunoreactive score (IRS) for immunohistochemical estrogen receptor detection (ER-ICA) in breast cancer tissue. Pathologe 8(3):138–140PubMed

23.

Schelfout K et al (2004) Contrast-enhanced MR imaging of breast lesions and effect on treatment. Eur J Surg Oncol 30(5):501–507PubMedCrossRef

24.

Harms SE et al (1993) MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation. Radiology 187(2):493–501PubMed

25.

Morrow M (2004) Magnetic resonance imaging in the preoperative evaluation of breast cancer: primum non nocere. J Am Coll Surg 198(2):240–241PubMedCrossRef

26.

Fisher B et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347(16):1233–1241PubMedCrossRef

27.

Bartelink H et al (2001) Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med 345(19):1378–1387PubMedCrossRef

28.

Veronesi U et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347(16):1227–1232PubMedCrossRef

29.

Saphner T, Tormey DC, Gray R (1996) Annual hazard rates of recurrence for breast cancer after primary therapy. J Clin Oncol 14(10):2738–2746PubMed

30.

Lehman CD et al (2005) Added cancer yield of MRI in screening the contralateral breast of women recently diagnosed with breast cancer: results from the International Breast Magnetic Resonance Consortium (IBMC) trial. J Surg Oncol 92(1):9–15; discussion 15–16PubMedCrossRef

31.

Touboul E et al (1999) Local recurrences and distant metastases after breast-conserving surgery and radiation therapy for early breast cancer. Int J Radiat Oncol Biol Phys 43(1):25–38PubMed

32.

Haffty BG et al (1996) Ipsilateral breast tumor recurrence as a predictor of distant disease: implications for systemic therapy at the time of local relapse. J Clin Oncol 14(1):52–57PubMed

33.

Freedman GM, Fowble BL (2000) Local recurrence after mastectomy or breast-conserving surgery and radiation. Oncology (Williston Park) 14(11):1561–1581; discussion 1581–1582, 1582–1584

34.

Clarke M et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366(9503):2087–2106PubMed

35.

Fredriksson I et al (2003) Risk factors for local recurrence after breast-conserving surgery. Br J Surg 90(9):1093–1102PubMedCrossRef

36.

Ghossein NA et al (1992) Breast cancer. Importance of adequate surgical excision prior to radiotherapy in the local control of breast cancer in patients treated conservatively. Arch Surg 127(4):411–415PubMed

37.

Coombs NJ, Boyages J (2005) Multifocal and multicentric breast cancer: does each focus matter? J Clin Oncol 23(30):7497–7502PubMedCrossRef

38.

Blair S et al (2006) The efficacy of breast MRI in predicting breast conservation therapy. J Surg Oncol 94(3):220–225PubMedCrossRef

39.

Kristoffersen Wiberg M et al (2002) Value of MR imaging in clinical evaluation of breast lesions. Acta Radiol 43(3):275–281PubMedCrossRef

40.

Bone B et al (1996) Sensitivity and specificity of MR mammography with histopathological correlation in 250 breasts. Acta Radiol 37(2):208–213PubMedCrossRef

41.

Stomper PC et al (1995) Suspect breast lesions: findings at dynamic gadolinium-enhanced MR imaging correlated with mammographic and pathologic features. Radiology 197(2):387–395PubMed

42.

Morris EA (2001) Cancer staging with breast MR imaging. Magn Reson Imaging Clin N Am 9(2):333–344, vi–viiPubMed

43.

Monostori Z et al (1991) Limitations in distinguishing malignant from benign lesions of the breast by systematic review of mammograms. Surg Gynecol Obstet 173(6):438–442PubMed

44.

Hadjiiski L et al (2004) Improvement in radiologists’ characterization of malignant and benign breast masses on serial mammograms with computer-aided diagnosis: an ROC study. Radiology 233(1):255–265PubMedCrossRef

45.

Roubidoux MA et al (2004) Invasive cancers detected after breast cancer screening yielded a negative result: relationship of mammographic density to tumor prognostic factors. Radiology 230(1):42–48PubMedCrossRef

46.

Echevarria JJ et al (2006) Overall breast density in MR mammography: diagnostic and therapeutic implications in breast cancer. J Comput Assist Tomogr 30(1):140–147PubMedCrossRef

Titel: Influence of preoperative MRI on the surgical management of patients with operable breast cancer
verfasst von: Michael Braun
Martin Pölcher
Simone Schrading
Oliver Zivanovic
Theresa Kowalski
Uta Flucke
Claudia Leutner
Tong-Wong Park-Simon
Christian Rudlowski
Walther Kuhn
Christiane K. Kuhl
Publikationsdatum: 01.09.2008
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 1/2008
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-007-9767-5

Neu im Fachgebiet Onkologie

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Influence of preoperative MRI on the surgical management of patients with operable breast cancer

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Onkologie

Prostatakarzinom: EU initiiert neues Screeningkonzept

Blasenkarzinom – Biomarker statt Zytologie?

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Adjuvante Brustkrebstherapie: Doppelt hält besser

Update Onkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2008

Medical cost-offsets from psychosocial care in breast cancer

Association of polymorphisms of angiogenesis genes with breast cancer

The CASP8 -652 6N del promoter polymorphism and breast cancer risk: a multicenter study

MAZ drives tumor-specific expression of PPAR gamma 1 in breast cancer cells

Efficacy of three potent steroid sulfatase inhibitors: pre-clinical investigations for their use in the treatment of hormone-dependent breast cancer

Histologic grading is an independent prognostic factor in invasive lobular carcinoma of the breast

Neu im Fachgebiet Onkologie

Prostatakarzinom: EU initiiert neues Screeningkonzept

Blasenkarzinom – Biomarker statt Zytologie?

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Adjuvante Brustkrebstherapie: Doppelt hält besser

Update Onkologie