Olivas-Maguregui S, Villaseñor-Navarro Y, Ferrari-Carballo T, Morales-Chairez V, Michel-Ortega RM, Cerón-Lizarraga T, Silva-Godínez JC, Arrieta O

Language: English
References: 31
Page: 382-389
PDF size: 187.21 Kb.

ABSTRACT

Background. The presence and detection of multifocal and multicentric disease significantly increases the risk of recurrence and changes the best therapeutic approach in patients with breast cancer. Mammography has low sensitivity to detect multiple malignant foci in patients with dense breast parenchyma. We prospectively evaluated Magnetic Resonance Imaging (MRI) as part of preoperative assessment. Material and methods. Women with clinical and radiological suspicion of breast cancer and dense breast parenchyma (› 75% dense tissue) were included. All patients underwent mammography, ultrasonogram and MRI prior to surgery. Surgical specimens were used for the detection of multifocal and multicentric disease. Patients who required neoadjuvant chemotherapy or radiotherapy were excluded. Results. Nineteen patients were evaluated. Histological diagnosis was confirmed in 14 patients, multifocal and multicentric disease was found in five and two patients, respectively. Sensitivity and accuracy to detect multiple malignant foci were 42 and 64%, respectively, for mammography plus ultrasound and 100 and 92% for MRI (p ‹ 0.05). Conclusions. MRI is more sensible and has a better accuracy than mammography plus ultrasound to detect both multicentric and multifocal breast cancer in women with dense breast parenchyma. MRI can improve preoperative assessment of breast cancer in this group of patients.

REFERENCES

1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005, 55: 74-108.

2. Veronesi U, Boyle P, Goldhirsch A, Orecchia R, Viale G. Breast cancer. Lancet 2005; 365: 1727-41.

3. Holland R, Veling SMJ, Mravunac M, Hendriks JHCL. Histologic multifocality of Tis, T1, T1-2 breast carcinomas: implication for clinical trials of breast-conserving surgery. Cancer 1985; 56: 979-90.

4. Ghossein NA, Alpert S, Barba J, Pressman P, Stacey P, Lorenz E, et al. Breast cancer. Importance of adequate surgical excision prior to radiotherapy in the local control of breast cancer in patients treated conservatively. Arch Surg 1992; 127: 411-5.

5. Osteen RT. Selection of patients for breast-conserving surgery. Cancer 1994; 74: 366-71.

6. Silverstein MJ, Skinner KA, Lomis TJ. Predicting axillary nodal positivity in 2282 patients with breast carcinoma. World J Surg 2001; 25: 767-72.

7. Mandelson MT, Oestreicher N, Porter PL, White D, Finder CA, Taplin SH, White E. Breast density as a predictor of mammographic mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst 2000; 92: 1081-7.

8. Kolb TM, Lichy J, Newhouse JH. Comparison of the perfomance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 2002; 225: 165-75.

9. Saarenmaa I, Salminen T, Geiger U, Heikkinen P, Hyvarinen S, Isola J, et al. The effect of age and density of the breast on the sensitivity of breast cancer diagnostic by mammography and ultrasonography. Breast Cancer Res Treat 2001; 67: 117-23.

10. Morris EA, Liberman L, Ballon DJ, Robson M, Abramson AF, Heerdt A, Dershaw DD. MRI of Occult Breast Carcinoma in a High-Risk Population. Am J Roentgenol 2003; 181: 619-26.

11. Deurlo EE, Peterse JL, Rutgers EJ, Besnard AP, Muller SH, Gliluis KG. Additional breast lesions in patients eligible for brest-conserving therapy by MRI: impact on preoperative management and potential benefit of computarised analysis. Eur J Cancer 2005; 41: 1393-401.

12. Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med 2004; 351: 427-37.

13. Wiener JI, Schilling KJ, Adami C, Obuchowski NA. Assessment of suspected breast cancer by MRI: a prospective clinical trial using a kinetic and morphologic analysis. Am J Roentgenol 2005; 184: 878-86.

14. Hylton N. Magnetic resonance imaging of the breast: opportunities to improve breast cancer management. J Clin Oncol 2005; 23: 1678-84.

15. Liberman L, Menell JH. Breast Imaging Reporting and Date System (BI-RADS). Radiol Clin North Am 2002; 40: 409-30.

16. Amat S, Penault-Llorca F, Cure H, Le Boudec G, Achard JL, Van Praagh I, et al. Scarff-Bloom-Richardson (SBR) grading: a pleiotropic marker of chemosensitivity in invasive ductal breast carcinomas treated by neoadjuvant chemotherapy. Int J Oncol 2002; 20: 791-6.

17. Fernandez-Sanchez M, Gamboa-Dominguez A, Uribe N, Garcia-Ulloa AC, Flores-Estrada D, Candelaria M, Arrieta O. Clinical and pathological predictors of the response to neoadjuvant anthracycline chemotherapy in locally advanced breast cancer. Med Oncol 2006; 23(2): 171-83.

18. Sardanelli F, Giuseppetti GM, Panizza P, Bazzocchi M, Fausto A, Simonetti G, et al. Sensitivity of MRI Versus Mammography for Detecting Foci of Multifocal, Multicentric Breast Cancer in Fatty and Dense Breasts Using the Whole-Breast Pathologic Examination as a Gold Standard. Am J Roentgenol 2004; 183: 1149-57.

19. Van Goethem M, Schelfout K, Dijckmans L, Van Der Auwera JC, Weyler J, Verslegers I, et al. MR mammography in the preoperative staging of breast cancer in patients with dense breast tissue: comparison with mammography and ultrasound. Eur Radiol 2004; 14: 809-16.

20. Van Goethem M, Schelfout K, Dijckmans L, Van Der Auwera JC, Weyler J, Verslegers I, et al. MR mammography in the preoperative staging of breast cancer in patients with dense breast tissue: comparison with mammography and ultrasound. Eur Radiol 2004; 14: 809-16.

21. Egan RL. Multicentric breast carcinomas: clinical-radiographic-pathologic whole organ studies and 10-year survival. Cancer 1982; 49: 1123-30.

22. Luciani A, Dao TH, Lapeyre M, Schwarzinger M, Debaecque C, Lantieri L, et al. Simultaneous Bilateral Breast and High-Resolution Axillary MRI of Patients with Breast Cancer: Preliminary Results. Am J Roentgenol 2004; 182: 1059-67.

23. Liberman L, Morris EA, Lee MJ-Y, Kaplan JB, LaTrenta LR, Menell JH, et al. Breast Lesions Detected on MR Imaging: Features and Positive Predictive Value. Am J Roentgenol 2002; 179: 171-8.

24. Veronesi U, Salvadori B, Luini A. Conservative treatment of early breast cancer: long-term results of 1232 cases treated with quadrantectomy, axillary dissection and radiotherapy. Ann Surg 1990; 211: 250-9.

25. Harris JR, Recht A, Connolly J. Conservative surgery and radiotherapy for early breast cancer. Cancer 1990; 66: 1427-38.

26. Hlawatsch A, Teifke A, Schmidt M, Thelen M. Preoperative assessment of breast cancer: sonography versus MR imaging. Am J Roentgenol 2002; 179: 1493-501.

27. Kneeshaw PJ, Turnbull LW, Drew PJ. Current applications and future direction of MR mammography. Br J Cancer 2003; 88: 4-10.

28. Esserman L, Hylton N, Yassa L, Barclay J, Frankel S, Sickles E. Utility of Magnetic Resonance Imaging in the management of breast cancer: evidence for improved preoperative stanging. Am J Clin Oncol 1999; 17: 110-9.

29. Vaidya J, Vyas J, Chinoy R, Merchant N, Sharma O, Mittra I. Multicentricity of breast cancer: whole-organ analysis and clinical implications. Br J Cancer 1996; 74: 820-4.

30. Drew PJ, Chatterjee S, Turnbull LW, Read J, Carleton PJ, Fox JN, et al. Dynamic Contrast Enhanced Magnetic Resonance Imaging of the Breast Is Superior to Triple Assessment for the Pre-Operative Detection of Multifocal Breast Cancer. Annals of Surgical Oncology 1999; 6: 599-603.

31. Coombs NJ, Boyages J. Multifocal and Multicentric Breast Cancer: Does Each Focus Matter. J Clin Oncol 2005; 23: 7497-502.