Is it worth to perform preoperative MRI for breast cancer after mammography, tomosynthesis and ultrasound?
Adult
Aged
Aged, 80 and over
Breast
/ pathology
Breast Density
Breast Neoplasms
/ diagnostic imaging
Female
Humans
Image Processing, Computer-Assisted
/ methods
Magnetic Resonance Imaging
Mammography
Mastectomy
Middle Aged
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Ultrasonography, Mammary
Breast Ultrasonography
Breast cancer
Breast density
Digital Mammography
Magnetic resonance imaging
Journal
Magnetic resonance imaging
ISSN: 1873-5894
Titre abrégé: Magn Reson Imaging
Pays: Netherlands
ID NLM: 8214883
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
03
10
2018
revised:
20
11
2018
accepted:
19
12
2018
pubmed:
24
12
2018
medline:
2
7
2019
entrez:
24
12
2018
Statut:
ppublish
Résumé
The use of preoperative breast MRI remains controversial despite being the most sensitive technique for the detection of breast malignancies. To evaluate the benefit of preoperative breast MRI after performing the three conventional techniques (DM, US, DBT). To analyze the influence of breast density in the sensitivity of the different imaging techniques. Retrospective review of 280 histologically confirmed breast cancers in 192 women. We reviewed the medical records and evaluated the change of treatment induced by MRI. Also, we assessed the reports of DM and the combination of the different imaging techniques, and categorized them according to ACR density (a-d) and as negative (BI-RADS 1-3) or positive (BIRADS 4 or 5). The gold standard was the pathologic assessment of the surgical specimen. The sensitivity of the different techniques was compared using McNemar test. Among these 192 women the use of MRI did not significantly increase the mastectomy rate (from 16.6% to 17.6%; p = 0.5). The addition of any technique demonstrated a higher sensitivity than DM alone. The sensitivity of DM alone was 52.5% while using all the techniques, including MRI, was 94.3% (p < 0.001). Regardless of breast density pattern, the addition of any technique significantly increased the sensitivity of DM (p < 0.001). The addition of MRI to the three conventional techniques increased the sensitivity but did not significantly modify the rate of mastectomies. Additional techniques increased the sensitivity of DM in both dense and non-dense breasts.
Sections du résumé
BACKGROUND
The use of preoperative breast MRI remains controversial despite being the most sensitive technique for the detection of breast malignancies.
PURPOSE
To evaluate the benefit of preoperative breast MRI after performing the three conventional techniques (DM, US, DBT). To analyze the influence of breast density in the sensitivity of the different imaging techniques.
MATERIAL AND METHODS
Retrospective review of 280 histologically confirmed breast cancers in 192 women. We reviewed the medical records and evaluated the change of treatment induced by MRI. Also, we assessed the reports of DM and the combination of the different imaging techniques, and categorized them according to ACR density (a-d) and as negative (BI-RADS 1-3) or positive (BIRADS 4 or 5). The gold standard was the pathologic assessment of the surgical specimen. The sensitivity of the different techniques was compared using McNemar test.
RESULTS
Among these 192 women the use of MRI did not significantly increase the mastectomy rate (from 16.6% to 17.6%; p = 0.5). The addition of any technique demonstrated a higher sensitivity than DM alone. The sensitivity of DM alone was 52.5% while using all the techniques, including MRI, was 94.3% (p < 0.001). Regardless of breast density pattern, the addition of any technique significantly increased the sensitivity of DM (p < 0.001).
CONCLUSIONS
The addition of MRI to the three conventional techniques increased the sensitivity but did not significantly modify the rate of mastectomies. Additional techniques increased the sensitivity of DM in both dense and non-dense breasts.
Identifiants
pubmed: 30580077
pii: S0730-725X(18)30503-4
doi: 10.1016/j.mri.2018.12.005
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
317-322Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.