The purpose of this analysis is to explore the potential diagnostic gain provided by the viscoelastic shear properties of breast lesions for the improvement of the specificity of contrast enhanced dynamic MR mammography (

BackgroundTumour size in breast cancer influences therapeutic decisions. The purpose of this study was to evaluate sizing of primary breast cancer using mammography, sonography and magnetic resonance imaging (MRI) and thereby establish which imaging method most accurately corresponds with the size of the histological result.MethodsData from 121 patients with primary breast cancer were analysed in a retrospective study. The results were divided into the groups “ductal carcinoma in situ (DCIS)”, invasive ductal carcinoma (IDC) + ductal carcinoma in situ (DCIS)”, “invasive ductal carcinoma (IDC)”, “invasive lobular carcinoma (ILC)” and “other tumours” (tubular, medullary, mucinous and papillary breast cancer). The largest tumour diameter was chosen as the sizing reference in each case. Bland-Altman analysis was used to determine to what extent the imaging tumour size correlated with the histopathological tumour sizes.ResultsTumour size was found to be significantly underestimated with sonography, especially for the tumour groups IDC + DCIS, IDC and ILC. The greatest difference between sonographic sizing and actual histological tumour size was found with invasive lobular breast cancer. There was no significant difference between mammographic and histological sizing. MRI overestimated non-significantly the tumour size and is superior to the other imaging techniques in sizing of IDC + DCIS and ILC.ConclusionsThe histological subtype should be included in imaging interpretation for planning surgery in order to estimate the histological tumour size as accurately as possible.

The achievement of 3-dimensional, T2-weighted TSE magnetic resonance imaging with isotropic and high spatial resolution and interactive 3-dimensional visualization essentially improve the diagnostic potential of magnetic resonance imaging.

In this study, the combination of MRE and ce MRI could increase the diagnostic performance of breast MRI. Further investigations of larger cohorts and smaller lesions (in particular those only visible on MRI) are necessary to validate these results.

http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10100968/-/DC1.