Contrast-Enhanced MRI of the Breast after Limited Surgery and Radiation Therapy

Heywang‐Köbrunner, Sylvia H.; Schlegel, Andrea; Beck, Rainer; Wendt, Thomas; Kellner, Wolfgang; Lommatzsch, B.; Untch, Michael; Nathrath, W

doi:10.1097/00004728-199311000-00009

Cited by 132 publications

(53 citation statements)

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“…DYNAMIC CONTRAST-ENHANCED magnetic resonance imaging (MRI) in breast imaging has demonstrated an excellent sensitivity but a questionable specificity in the diagnosis of primary (1-9) and recurrent (10)(11)(12)(13)(14) cancer since its introduction more than a decade ago. In the diagnosis of primary breast cancer, the technique suffers from a significant overlap between the enhancement patterns measured in malignant and benign (especially fibroadenoma) lesions.…”

mentioning

confidence: 99%

Characterization of N-ethyl-N-nitrosourea-induced malignant and benign breast tumors in rats by using three MR contrast agents

Wang

Carpenter

et al. 1999

J. Magn. Reson. Imaging

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mentioning

confidence: 99%

Characterization of N-ethyl-N-nitrosourea-induced malignant and benign breast tumors in rats by using three MR contrast agents

Wang

Carpenter

et al. 1999

J. Magn. Reson. Imaging

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“…The presence of a noncontrast enhanced scar at MRI has a high negative predictive value for cancer recurrence. However, a normal increase in the vascularization may be observed in the surgical site up to 18 months following radiotherapy (16) . Several authors have also described the relevance of breast MRI in the preoperative staging, considering that such method is more sensitive than conventional imaging methods to evaluate the tumor extent, even in cases of ductal carcinoma in situ and invasive lobular carcinoma (15) .…”

Section: Discussionmentioning

confidence: 97%

Indicações de ressonância magnética das mamas em um centro de referência em oncologia

et al. 2011

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Objective: To evaluate and discuss the indications for breast magnetic resonance imaging in an oncology reference center. Materials and Methods: Retrospective study approved by the Committee for Ethics in Research of the institution and developed through a review of patients' records and clinical reports. All the breast magnetic resonance studies performed in the period from July 2008 to July 2009 (n = 529) were included. Results: Mean patients' age was 49 years, ranging from 17 to 86 years. Family history of breast and/or ovarian cancer was present in 162 patients (30.6%). Most common indications for breast magnetic resonance imaging included inconclusive mammographic/sonographic findings (48.8%), evaluation of tumor recurrence/surgical scar after breast surgery (15.1%), disease staging/surgical planning (11.7%) and screening in high-risk patients (8.5%). Conclusion: In spite of inconclusive findings at conventional imaging studies being the most common indication for breast magnetic resonance imaging, there is no evidence in the literature supporting such a conduct. Because of its high sensitivity and high rate of false positive results, magnetic resonance imaging should be appropriately indicated in order to avoid unnecessary procedures. Once such method is appropriately indicated, it may contribute in the decision making process, constituting an essential tool in the assessment of breast lesions. Keywords: Magnetic resonance imaging; Breast neoplasms; Early detection of cancer.Objetivo: Avaliar e discutir as indicações de ressonância magnética das mamas em um centro de referência oncoló-gico. Materiais e Métodos: Estudo retrospectivo, aprovado pelo Comitê de Ética e Pesquisa da instituição, conduzido através da revisão de prontuários e laudos médicos. Foram incluídos todos os exames de ressonância magnética das mamas realizados no período de julho de 2008 a julho de 2009 (n = 529). Resultados: A idade média das pacientes foi de 49 anos, variando de 17 a 86 anos. História familiar de câncer de mama e/ou ovário esteve presente em 162 pacientes (30,6%). As indicações mais comuns de ressonância magnética das mamas foram esclarecimento de achados inconclusivos na mamografia e/ou ultrassom (48,8%), avaliação de recorrência tumoral/cicatriz cirúrgica (15,1%), estadiamento/planejamento cirúrgico (11,7%) e rastreamento de pacientes de alto risco (8,5%). Conclusão: Apesar de achados inconclusivos nos exames convencionais serem a indicação mais comum de ressonância magnética das mamas, não há evidências que justifiquem esta conduta na literatura. Em razão da sua alta sensibilidade e percentual de falso-positivos, este exame deve ser adequadamente indicado, para evitar a realização de procedimentos desnecessários. Se bem indicada, a ressonância magnética pode contribuir para o processo de tomada de decisão e constitui uma ferramenta fundamental na avaliação de lesões mamárias. Unitermos: Imagem por ressonância magnética; Neoplasias da mama; Detecção precoce de câncer. AbstractResumo

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“…1 MRI has proven to be a valuable additional tool for detecting and excluding recurrent tumor 18 months after radiation therapy. 27 After 18 months, enhancement of areas of radiation fibrosis is rare. 27 MRI has proved to be more sensitive than mammography for detecting recurrence in the posttreatment breast, which may obscure conventional images due to scarring, distortion, and density postsurgical changes (Fig 3).…”

Section: Evaluation Of the Breast After Conservation Therapymentioning

confidence: 99%

“…27 After 18 months, enhancement of areas of radiation fibrosis is rare. 27 MRI has proved to be more sensitive than mammography for detecting recurrence in the posttreatment breast, which may obscure conventional images due to scarring, distortion, and density postsurgical changes (Fig 3). 28,29 In a study of 105 patients, the specificity of MRI for detecting recurrence was 93% compared with 67% for clinical examination combined with mammography, and the sensitivity of MRI was 100%, compared with mammography alone.…”

Section: Evaluation Of the Breast After Conservation Therapymentioning

confidence: 99%