Accuracy of Preoperative Breast MRI Versus Conventional Imaging in Measuring Pathologic Extent of Invasive Lobular Carcinoma

Hovis, Keegan; Lee, Janie M.; Hippe, Daniel S.; Linden, Hannah M.; Flanagan, Meghan R.; Kilgore, Mark R.; Yee, Janis M.; Partridge, Savannah C.; Rahbar, Habib

doi:10.1093/jbi/wbab015

Cited by 22 publications

(9 citation statements)

References 35 publications

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“…In the literature, the correlation coefficients between tumor sizes at imaging and histopathology were 0.26–0.76 for mammography, 0.57–0.68 for ultrasound, and 0.75–0.80 for MRI [ 3 4 5 ]. With regard to the histopathological type, the presence of ductal carcinoma in situ (DCIS) or invasive lobular carcinoma has been considered a factor associated with underestimation on conventional imaging [ 6 7 8 ]. However, in a prospective study including 593 patients with biopsy-proven invasive breast cancer, the sensitivity of preoperative MRI was significantly improved compared with that of mammography and ultrasound for DCIS detection (84.9% vs. 36.7%) [ 6 ].…”

Section: Evaluation Of Tumor Sizementioning

confidence: 99%

“…However, in a prospective study including 593 patients with biopsy-proven invasive breast cancer, the sensitivity of preoperative MRI was significantly improved compared with that of mammography and ultrasound for DCIS detection (84.9% vs. 36.7%) [ 6 ]. In addition, invasive lobular carcinoma is more accurately depicted on preoperative MRI than on mammography and ultrasound [ 7 8 ]. Thus, MRI is the most accurate modality for tumor size evaluation among the imaging techniques for breast tumors [ 4 5 ].…”

Section: Evaluation Of Tumor Sizementioning

confidence: 99%

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Breast Magnetic Resonance Imaging for Patients With Newly Diagnosed Breast Cancer: A Review

Kim

Cho

2022

J Breast Cancer

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Despite the high sensitivity and widespread use of preoperative magnetic resonance imaging (MRI), the American Cancer Society and the National Comprehensive Cancer Network guidelines do not recommend the routine use of preoperative MRI owing to the conflicting results and lack of clear benefit to the surgical outcome (reoperation and mastectomy) and long-term clinical outcomes (local recurrence and metachronous contralateral breast cancer). Preoperative MRI detects additional cancers that are occult at mammography and ultrasound but increases the rate of mastectomy. Concerns about overdiagnosis and overtreatment of preoperative MRI might be mitigated by adjusting the confounding factors when conducting studies, using the state-of-the-art image-guided biopsy technique, applying the radiologists’ cumulative experiences in interpreting MRI findings, and performing multiple lumpectomies in patients with multicentric cancer. Among the various imaging methods, dynamic contrast-enhanced MRI has the highest accuracy in predicting pathologic complete response after neoadjuvant chemotherapy. Prospective trials aimed at applying the MRI information to the de-escalation of surgical or radiation treatments are underway. In this review, current studies on the clinical outcomes of preoperative breast MRI are updated, and circumstances in which MRI may be useful for surgical planning are discussed.

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Section: Evaluation Of Tumor Sizementioning

confidence: 99%

Section: Evaluation Of Tumor Sizementioning

confidence: 99%

Breast Magnetic Resonance Imaging for Patients With Newly Diagnosed Breast Cancer: A Review

Kim

Cho

2022

J Breast Cancer

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“…5 Benefits of preoperative breast MRI include better prediction of size and extent of disease compared to conventional imaging such as mammography and ultrasound, and increased sensitivity to identify multifocal and multicentric disease and for assessing the contralateral breast for occult disease. [5][6][7][8][9][10][11] The diffuse, infiltrating nature of ILC often results in disease extent underestimation on mammograms and ultrasound. 10,12 Lobular histology has been shown to be a predicting factor for positive surgical margins.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Preoperative Breast MRI on Timing of Surgical Management in Newly Diagnosed Breast Cancer

Gauthier,

Seely,

Cordeiro

et al. 2023

Can Assoc Radiol J

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Purpose: Preoperative breast MRI has been recommended at our center since 2016 for invasive lobular carcinoma and cancers in dense breasts. This study examined how preoperative breast MRI impacted surgical timing and outcomes for patients with newly diagnosed breast cancer. Methods: Retrospective single-center study of consecutive women diagnosed with new breast cancer between June 1, 2019, and March 1, 2021, in whom preoperative breast MRI was recommended. MRI, tumor histology, breast density, post-MRI biopsy, positive predictive value of biopsy (PPV3), surgery, and margin status were recorded. Time from diagnosis to surgery was compared using t-tests. Results: There were 1054 patients reviewed, and 356 were included (mean age 60.9). Of these, 44.4% (158/356) underwent preoperative breast MRI, and 55.6% (198/356) did not. MRI referral was more likely for invasive lobular carcinoma, multifocal disease, and younger patients. Following preoperative MRI, 29.1% (46/158) patients required additional breast biopsies before surgery, for a PPV3 of 37% (17/46). The time between biopsy and surgery was 55.8 ± 21.4 days for patients with the MRI, compared to 42.8 ± 20.3 days for those without ( P < .00001). MRI was not associated with the type of surgery (mastectomy vs breastconserving surgery) ( P = .44) or rate of positive surgical margins ( P = .52). Conclusion: Among patients who underwent preoperative breast MRI, we observed significant delays to surgery by almost 2 weeks. When preoperative MRI is requested, efforts should be made to mitigate associated delays.

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“…Breast magnetic resonance imaging (MRI) is an indispensable modality in the detection of breast tumors (1). Current applications of breast MRI include the staging of known cancers (2)(3)(4)(5), contralateral breast examination (6)(7)(8), breast cancer screening for women at high risk (9,10), treatment evaluation after neoadjuvant chemotherapy (11), and the evaluation of carcinomas of unknown primary origin (12,13).…”

Section: Introductionmentioning

confidence: 99%

A simplified scoring protocol to improve diagnostic accuracy with the breast imaging reporting and data system in breast magnetic resonance imaging

Zhong¹,

Li²,

Zhu³

et al. 2022

Quant Imaging Med Surg

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Background:The breast imaging reporting and data system (BI-RADS) lexicon provides a standardized terminology for describing leision characteristics but does not provide defined rules for converting specific imaging features into diagnostic categories. The inter-reader agreement of the BI-RADS is moderate. In this study, we explored the use of a simplified protocol and scoring system for BI-RADS categorization which integrates the morphologic features (MF), kinetic time-intensity curve (TIC), and apparent diffusion coefficient (ADC) values with equal weights, with a view to providing a convenient and practical method for breast magnetic resonance imaging (MRI) and improving the inter-reader agreement and diagnostic performance of BI-RADS.Methods: This cross-sectional, retrospective, single-center study included 879 patients with 898 histopathologically verified lesions who underwent an MRI scan on a 3.0 Tesla GE Discovery 750 MRI scanner between January 1, 2017, and June 30, 2020. The BI-RADS categorization of the studied lesions was assessed according to the sum of the assigned scores (the presence of malignant MF, lower ADC, and suspicious TIC each warranted a score of +1). Total scores of +2 and +3 were classified as category 5, scores of +1 were classified as category 4, and scores of +0 but with other lesions of interest were classified as category 3. The receiver operating characteristic (ROC) curves were plotted, and the sensitivity, specificity, and accuracy of this categorization were investigated to assess its efficacy and its consistency with pathology.Results: There were 472 malignant, 104 risk, and 322 benign lesions. Our simplified scoring protocol had high diagnostic accuracy, with an area under curve (AUC) value of 0.896. In terms of the borderline effect of pathological risk and category 4 lesions, our results showed that when risk lesions were classified together with malignant ones, the AUC value improved (0.876 vs. 0.844 and 0.909 vs. 0.900). When category 4 and 5 lesions were classified as malignant, the specificity, accuracy, and AUC value decreased (82.3% vs. 93.2%, 89.3% vs. 90.2%, and 0.876 vs. 0.909, respectively). Therefore, to improve the diagnostic accuracy of the protocol for BI-RADS categorization, only category 5 lesions should be considered to be malignant. Conclusions:Our simplified scoring protocol that integrates MF, TIC, and ADC values with equal

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Accuracy of Preoperative Breast MRI Versus Conventional Imaging in Measuring Pathologic Extent of Invasive Lobular Carcinoma

Cited by 22 publications

References 35 publications

Breast Magnetic Resonance Imaging for Patients With Newly Diagnosed Breast Cancer: A Review

Breast Magnetic Resonance Imaging for Patients With Newly Diagnosed Breast Cancer: A Review

The Impact of Preoperative Breast MRI on Timing of Surgical Management in Newly Diagnosed Breast Cancer

A simplified scoring protocol to improve diagnostic accuracy with the breast imaging reporting and data system in breast magnetic resonance imaging

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