Breast Cancers Not Detected at MRI: Review of False-Negative Lesions

Shimauchi, Akiko; Jansen, Sanaz A.; Abé, Hiroyuki; Jaskowiak, Nora; Schmidt, Robert A.; Newstead, Gillian M.

doi:10.2214/ajr.09.3568

Cited by 58 publications

(41 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Non-mass-like enhancements, such as DCIS lesions, are more difficult to detect in the presence of moderate/marked background enhancement. These results are consistent with those described in previous reports [8][9][10]. Plausible explanations for the lack of adequate breast tumour delineation in breast MRI examinations include differences in histological features, tumour size, and/or the degree of background enhancement [10].…”

Section: Discussionsupporting

confidence: 92%

Does the degree of background enhancement in breast MRI affect the detection and staging of breast cancer?

2011

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 92%

Does the degree of background enhancement in breast MRI affect the detection and staging of breast cancer?

2011

View full text Add to dashboard Cite

show abstract

“…Focally, asymmetrically or regionally distributed BPE could cause false-positive interpretation, and by contrast, additional malignant foci around the index cancer could be masked by adjacent parenchymal enhancement causing false-negative interpretation. 26,27 The accuracy was significantly lower in patients with moderate or marked BPE causing underestimation or overestimation of lesion extent. 28,29 Our results revealed that of 216 patients with weak BPE, only 21 (10%) patients had positive resection margin, and of 98 patients with strong BPE, 23 (23%) had positive resection margin.…”

Section: Discussionmentioning

confidence: 97%

Does background parenchymal enhancement on MRI affect the rate of positive resection margin in breast cancer patients?

Park¹,

Kang²,

Kim³

2015

BJR

View full text Add to dashboard Cite

Objective: The purpose of our study was to evaluate whether strong background parenchymal enhancement (BPE) would be a significant independent factor associated with positive resection margin in patients treated initially with breast-conserving surgery (BCS). Methods: Retrospective evaluation of breast MRI examinations of 314 patients with breast cancer was carried out. Breast cancer was histologically confirmed in all patients who underwent BCS from January 2008 to December 2010. BPE was dichotomized into weak (minimal or mild) and strong (moderate or marked) enhancement for statistical analysis. Histopathological features of attained specimens were evaluated by an experienced pathologist and were also dichotomized for statistical analysis. Results: On univariate analysis, positive extensive intraductal component (p , 0.001), strong BPE (p 5 0.001) and human epidermal growth factor receptor 2 (HER2) positivity (p 5 0.08) had significant association with positive surgical margin. Tumour size, axillary lymph node metastasis, nuclear grade, histological grade, lymphovascular invasion, oestrogen receptor and progesterone receptor did not show significant correlation with positive surgical margin. On multivariate analysis, the significant independent predictors were extensive intraductal component [odds ratio, 5.68; 95% confidence interval (CI), 2.72-11.82] and strong BPE (odds ratio, 2.39; 95% CI, 1.20-4.78). Conclusion: Strong BPE is a significant independent factor for positive resection margin along with positive extensive intraductal component, and performing MRI during the period of lower parenchymal enhancement is needed in patients with strong BPE. Advances in knowledge: As far as we know, this is the first study to reveal that BPE is a significant independent factor associated with positive resection margin.Overall survival after breast-conserving surgery (BCS) followed by adjuvant radiation therapy has been shown to be equivalent to that after mastectomy for early stage breast cancer.1-4 Nowadays, BCS has become the standard treatment for early stage breast cancer. However, the rate of local recurrence is higher in patients with BCS than in those with mastectomy, 2 and the most important predictor of local recurrence is margin status. 5 In a meta-analysis reporting local recurrence relative to margin status, odds ratio for local recurrence was 2.42 (p , 0.001) with a positive margin. 6 There are many known risk factors associated with positive resection margin, including younger age, less than 45 years of age, mammographic density of Category 4, larger tumour size, positive lymph nodes, tumour multifocality, the presence of microcalcification in mammography, lobular histology, higher grade, the presence of extensive intraductal component and the presence of lymphovascular invasion. 7-11Accurate pre-operative assessment of tumour extent is essential for surgical planning and for reducing positive surgical margin. Breast MRI has been widely used for preoperative evaluation of tumour extent and could substant...

show abstract

“…MRI displays high sensitivity for invasive breast cancer (including mammographically occult invasive breast cancer; ref. [31][32][33]; however, its use is limited, by its relatively low sensitivity in the detection of DCIS and low specificity for both invasive carcinoma and DCIS (34)(35)(36)(37).…”

Section: Discussionmentioning

confidence: 99%

A Multiparametric Serum Marker Panel as a Complementary Test to Mammography for the Diagnosis of Node-Negative Early-Stage Breast Cancer and DCIS in Young Women

Lacombe

Mangé

Bougnoux

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

Background: The sensitivity of mammography for the detection of small lesions, including node-negative early-stage (T1N0) primary breast cancer (PBC) and ductal carcinoma in situ (DCIS), is significantly decreased in young patients. From a clinical standpoint, an inconclusive mammogram reflects the inability of clinicians to confidently decide whether patients should be referred for biopsy or for follow-up with repeat imaging.Methods: Specific ELISAs were developed for a panel of 13 well-recognized breast autoantigens (HSP60, FKBP52, PRDX2, PPIA, MUC1, GAL3, PAK2, P53, CCNB1, PHB2, RACK1, RUVBL1, and HER2). Circulating autoantibody levels were measured in a cohort of 396 serum samples from histologically confirmed DCIS (n ¼ 87) or T1N0 PBC (n ¼ 153) and healthy controls (n ¼ 156).Results: Individually, antibodies against CCNB1, FKBP52, GAL3, PAK2, PRDX2, PPIA, P53, and MUC1 demonstrated discriminatory power between breast cancer and healthy control groups. At 90% sensitivity, the overall combined specificity of the autoantibody serum screening test was 42%. Adjustment for higher sensitivities of 95% and 99% resulted in 30% and 21% specificities, respectively (33% and 18% in T1N0 PBC and 28% and 21% in DCIS). Finally, in patients with node-negative early-stage breast cancer younger than 50 years, the autoantibody assay exhibited 59% specificity with a fixed sensitivity at 90%.Conclusions: Our autoantibody panel allows accurate detection of early breast cancer and DCIS, notably in younger patients.Impact: Clinical assessment of this autoantibody panel displays a potential to facilitate clinical management of early-stage breast cancer detection in cases of inconclusive mammogram. Cancer Epidemiol Biomarkers Prev; 23(9); 1834-42. Ó2014 AACR.

show abstract

Breast Cancers Not Detected at MRI: Review of False-Negative Lesions

Cited by 58 publications

References 28 publications

Does the degree of background enhancement in breast MRI affect the detection and staging of breast cancer?

Does the degree of background enhancement in breast MRI affect the detection and staging of breast cancer?

Does background parenchymal enhancement on MRI affect the rate of positive resection margin in breast cancer patients?

A Multiparametric Serum Marker Panel as a Complementary Test to Mammography for the Diagnosis of Node-Negative Early-Stage Breast Cancer and DCIS in Young Women

Contact Info

Product

Resources

About