Repeated surgeries in invasive lobular breast cancer with preoperative MRI: Role of additional carcinoma in situ and background parenchymal enhancement

Preibsch, Heike; Richter, V.; Bahrs, SD; Hattermann, V; Wietek, Beate; Bier, Georg; Kloth, Christopher; Blumenstock, Gunnar; Hahn, Markus; Staebler, Annette; Nikolaou, Konstantin; Wiesinger, Benjamin

doi:10.1016/j.ejrad.2017.02.045

Cited by 10 publications

(1 citation statement)

References 25 publications

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“…It is interesting to note that these findings were not corroborated by Preibsch et al, who found no association with BPE and DCIS measurement accuracy . Finally, there are also mixed data on BPE's effect on margin status at breast conservation therapy: one study demonstrated elevated BPE was an independent risk factor for positive margins, while another demonstrated no effect on reoperation rates for invasive lobular carcinomas . Given the limited number of studies to date and mixed results, further research on the effect of BPE on preoperative breast MRI extent of disease accuracy is warranted.…”

Section: Variability Of Qualitative Bpe Assessments and Effect On Diamentioning

confidence: 88%

Background parenchymal enhancement on breast MRI: A comprehensive review

Liao

Bancroft

Strigel

et al. 2019

Magnetic Resonance Imaging

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The degree of normal fibroglandular tissue that enhances on breast MRI, known as background parenchymal enhancement (BPE), was initially described as an incidental finding that could affect interpretation performance. While BPE is now established to be a physiologic phenomenon that is affected by both endogenous and exogenous hormone levels, evidence supporting the notion that BPE frequently masks breast cancers is limited. However, compelling data have emerged to suggest BPE is an independent marker of breast cancer risk and breast cancer treatment outcomes. Specifically, multiple studies have shown that elevated BPE levels, measured qualitatively or quantitatively, are associated with a greater risk of developing breast cancer. Evidence also suggests that BPE could be a predictor of neoadjuvant breast cancer treatment response and overall breast cancer treatment outcomes. These discoveries come at a time when breast cancer screening and treatment have moved toward an increased emphasis on targeted and individualized approaches, of which the identification of imaging features that can predict cancer diagnosis and treatment response is an increasingly recognized component. Historically, researchers have primarily studied quantitative tumor imaging features in pursuit of clinically useful biomarkers. However, the need to segment less well-defined areas of normal tissue for quantitative BPE measurements presents its own unique challenges. Furthermore, there is no consensus on the optimal timing on dynamic contrastenhanced MRI for BPE quantitation. This article comprehensively reviews BPE with a particular focus on its potential to increase precision approaches to breast cancer risk assessment, diagnosis, and treatment. It also describes areas of needed future research, such as the applicability of BPE to women at average risk, the biological underpinnings of BPE, and the standardization of BPE characterization. Level of Evidence: 3 Technical Efficacy Stage: 5

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Section: Variability Of Qualitative Bpe Assessments and Effect On Diamentioning

confidence: 88%

Background parenchymal enhancement on breast MRI: A comprehensive review

Liao

Bancroft

Strigel

et al. 2019

Magnetic Resonance Imaging

View full text Add to dashboard Cite

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Wohin entwickelt sich die operative Senologie?

Hahn

Gerber

2020

Gynäkologe

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Background Parenchymal Enhancement on Breast MRI: Assessment and Clinical Implications

2021

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Purpose of Review To present recent literature regarding the assessment and clinical implications of background parenchymal enhancement on breast MRI. Recent Findings The qualitative assessment of BPE remains variable within the literature, as well as in clinical practice. Several different quantitative approaches have been investigated in recent years, most commonly region of interest-based and segmentation-based assessments. However, quantitative assessment has not become standard in clinical practice to date. Numerous studies have demonstrated a clear association between higher BPE and future breast cancer risk. While higher BPE does not appear to significantly impact cancer detection, it may result in a higher abnormal interpretation rate. BPE is also likely a marker of pathologic complete response after neoadjuvant chemotherapy, with decreases in BPE during and after neoadjuvant chemotherapy correlated with pCR. In contrast, pre-treatment BPE does not appear to be predictive of pCR. The association between BPE and prognosis is less clear, with heterogeneous results in the literature. Summary Assessment of BPE continues to evolve, with heterogeneity in approaches to both qualitative and quantitative assessment. The level of BPE has important clinical implications, with associations with future breast cancer risk and treatment response. BPE may also be an imaging marker of prognosis, but future research is needed on this topic.

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Repeated surgeries in invasive lobular breast cancer with preoperative MRI: Role of additional carcinoma in situ and background parenchymal enhancement

Cited by 10 publications

References 25 publications

Background parenchymal enhancement on breast MRI: A comprehensive review

Background parenchymal enhancement on breast MRI: A comprehensive review

Wohin entwickelt sich die operative Senologie?

Background Parenchymal Enhancement on Breast MRI: Assessment and Clinical Implications

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