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Breast Dis. 2016 Feb 17;36(1):27-35. doi: 10.3233/BD-150195.

Enhancing patterns of breast cancer on preoperative dynamic contrast-enhanced magnetic resonance imaging and resection margin in breast conserving therapy.

Author information

1
Department of Diagnostic Radiology, College of Medicine, Sungkyunkwan University, Samsungchangwon hospital, Changwon, Korea.
2
Department of Diagnostic Radiology, College of Medicine, Inje University, Busan, Korea.
3
Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea.

Abstract

BACKGROUND:

The association between enhancing patterns of preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and resection margins after BCS has not been studied in detail before.

OBJECTIVE:

We investigated the association between surgical outcomes and enhancing patterns observed on DCE-MRI.

METHODS:

269 enhancing patterns on DCE-MRI scans were selected, and subdivided into the following groups: (1) a single mass-like enhancement, (2) a single non-mass-like enhancement (NME), (3) mass-like enhancing breast cancer with other mass-like enhancing lesions, and (4) mass-like enhancing breast cancer with additional NMEs. Associations between enhancing patterns on DCE-MRI and re-excision rate, size of specimen, and ratio of tumor/specimen were evaluated retrospectively.

RESULTS:

The conversion rate from breast conserving therapy (BCT) to mastectomy as a result of MRI findings was 13.4%, re-excision rate during BCT was 8.2% and excision rate of another suspicious lesion was 7.4%. The single NME group had the highest re-excision rate after BCT (22.2%) (p = 0.02). The ratio of tumor/specimen (p = 0.61) and mean specimen size (p = 0.38) were not influenced by enhancement patterns. The false positive rate and positive predictive values of using DCE-MRI for defining the extension of breast cancer was 22.2% and 71.4%, respectively.

CONCLUSION:

Enhancement patterns on DCE- MRI, especially NME, could increase re-excision rates.

KEYWORDS:

Breast neoplasm; breast conserving therapy; magnetic resonance imaging (MRI); mass; non-mass-like enhancement; re-excision

PMID:
27177341
DOI:
10.3233/BD-150195
[Indexed for MEDLINE]

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