Breast Magnetic Resonance Imaging and Its Impact on the Surgical Treatment of Breast Cancer

Abstract

Breast MRI focuses on the detection of multifocality, multicentricity, and bilaterality of newly diagnosed breast cancer. A retrospective study was carried out on 833 patients that were diagnosed and treated for breast cancer between January 2002 and December 2011. Patients were divided into two groups: those that had a presurgery breast MRI and those that did not. The two groups were compared on the basis of the several parameters. The aim of the study was to determine whether the use of MRI in breast cancer screening changes the initial treatment decision. In 18% of the patients, MRI revealed a multifocal or a multicentric unilateral breast cancer, a bilateral tumour, or a larger cancer than initially diagnosed. Most of these patients underwent a second-look breast ultrasound, with or without an additional biopsy. The percentage of mastectomies did not increase as a result of an MRI exam. Neoadjuvant chemotherapy was used more often and the percentage of reoperations decreased when an MRI was performed.

Role of MRI in the staging of breast cancer patients: does histological type and molecular subtype matter?

“…22,26 In addition, MRI has high sensitivity in the detection of multifocal, multicentric and contralateral tumours. 2,3 In this study, NST/IDC breast carcinomas had less multifocal and/or multicentric disease than other histological types. Besides, one-third of patients with multifocal and/or multicentric disease were identified only on MRI.…”

“…Pre-operative MR evaluation modifies the treatment in up to onethird of patients with breast cancer. 2,3 In our series, 10.6% of all patients underwent more aggressive surgery to remove multifocal and/or multicentric disease identified only on MRI. However, there is no agreement in the literature regarding the benefit to the patient provided by performing pre-operative MRI.…”

“…1 MRI can identify additional tumour sites in 15-27% of patients in the same breast and 3-10% of patients in the contralateral breast. 2,3 MRI is especially useful not only in patients with diagnosis of invasive lobular carcinoma, owing to the increased risk of additional sites of disease, but also in females with cancer diagnosis where it is difficult to accurately delineate the extent of disease on standard modalities.…”

Role of magnetic resonance imaging in the planning of breast cancer treatment strategies: comparison with conventional imaging techniques

“…MRI can reportedly identify additional tumors in the ipsilateral breast in 15–27% of patients and in the contralateral breast in 1–10%. A preoperative assessment by MRI prompts a change in the treatment strategy in up to a third of breast cancer patients ( 7 , 24 ) . The foci of breast cancer identified using MRI are clinically significant in the majority of cases ( 25 ) .…”

Breast and tumor volumes on 3D‐MRI and their impact on the performance of a breast conservative surgery (BCS)

“…In patients diagnosed with breast cancer, MRI can evaluate disease extent by determining the presence of multifocality, multicentricity, and contralaterality. In 3% of the cases, a contralateral tumor is diagnosed when MRI is added to conventional imaging, 2 whereas in 15%‐30% of the cases, tumor size is larger than initially diagnosed 3 . Determining disease extent more accurately is correlated with a decrease in the rate of re‐excisions 3 and a change in the treatment plan (toward a widest lumpectomy or neo‐adjuvant chemotherapy) in 10%‐20% of patients who underwent MRI 3 .…”