Menstrual cycle and age: influence on parenchymal contrast medium enhancement in MR imaging of the breast.

Müller-Schimpfle, Markus; Ohmenhäuser, K.; Stoll, Peter; Dietz, K; Claussen, Claus D.

doi:10.1148/radiology.203.1.9122383

Cited by 244 publications

(181 citation statements)

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“…Since there is a trend to use MRI for screening high-risk young women, diagnostic ambiguity will happen due to the very common condition of FCC identified in the same age cohort. MRI for detection of breast cancer should be performed in the second and third week of the menstrual cycles when FCC shows the weakest enhancement [18]. This will reduce the interference of unusual strong glandular enhancement coming from the FCC tissue and therefore decrease falsepositive diagnostic rate for breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging features of fibrocystic change of the breast

Chen

Liu

Baek

et al. 2008

Magnetic Resonance Imaging

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Purpose-Studies specifically reporting MR imaging of fibrocystic change (FCC) of the breast are very few and its MR imaging features are not clearly known. The purpose of this study was to analyze the MR imaging features of FCC of the breast.Materials and Methods-Thirty one patients of pathologically proved FCC of the breast were retrospectively reviewed. The MRI study was performed using a 1.5 T MR scanner with standard bilateral breast coil. The imaging protocol consisted of pre-contrast T1W imaging and dynamic contrast-enhanced axial T1W imaging. The MRI features were interpreted based on the morphologic and enhancement kinetic descriptors defined on ACR BIRADS-MRI lexicon.Results-FCC of the breast had a wide spectrum of morphologic and kinetic features on MRI. Two types of FCC were found, including a more diffuse type of non-mass lesion (12/31, 39%) showing benign enhancement kinetic pattern with medium wash-in in early phase (9/10, 90%) and a focal mass type lesion (11/31, 35%) with enhancement kinetic usually showing rapid up-slope mimicking a breast cancer (8/11, 73%).Conclusion-MRI is able to elaborate the diverse imaging features of fibrocystic change of the breast. Our result showed that FCC presenting as focal mass type lesion were usually over-diagnosed as malignancy. Understanding MR imaging of FCC is important to determine which cohort of patients should be followed up alone or receive aggressive management.

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Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging features of fibrocystic change of the breast

Chen

Liu

Baek

et al. 2008

Magnetic Resonance Imaging

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“…Since MRI of the breast seems to be especially susceptible for VEGF-induced changes in microvascular functions like vessel permeability, as could be shown by anti-VEGF treatment in nude mice (Pham et al, 1998), it seems reasonable to expect that the hormonal exposure of the breast influences parenchymal contrast enhancement patterns. This may explain why these patterns are changing depending on the stage of the patients' menstrual cycle (Müller-Schimpfle et al, 1997). …”

Section: Discussionmentioning

confidence: 99%

“…The assessment of tissue vascularization by Doppler sonographic measurements of vascular resistance and blood flow velocities suggests differences in vascular patterns between premenopausal and post-menopausal patients, and between tumour and normal breast tissue (Villena-Heinsen et al, 1998). Furthermore, parenchymal contrast enhancement patterns in MRI, which are thought to be caused by increased vessel density and permeability (Buadu et al, 1996), are changing depending on the stage of the patients' menstrual cycle (Müller-Schimpfle et al, 1997). Based upon these observations we hypothesized that the regulation of microvascular functions and angiogenesis in breast tissue, a well known target of ovarian steroid action, is likewise dependent on the hormonal milieu.…”

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confidence: 99%

Vascular endothelial growth factor A (VEGF-A) mRNA expression levels decrease after menopause in normal breast tissue but not in breast cancer lesions

Greb¹,

Maier²,

Wallwiener³

et al. 1999

Br J Cancer

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SummaryWe hypothesized that the regulation of microvascular functions and angiogenesis in breast tissue, a well known target of ovarian steroid action, is dependent on the hormonal exposure of the breast. Relative expression levels of VEGF-A (vascular endothelial growth factor A), a putative key regulator of angiogenesis in breast cancer, were analysed in the tumour and the adjacent non-neoplastic breast tissue of 19 breast cancer patients by quantitative reverse transcriptase polymerase chain reaction. In non-neoplastic breast specimens the expression levels of all detected VEGF-A-isoforms (189, 165, 121) were significantly higher in premenopausal compared to post-menopausal women (P = 0.02) and were inversely correlated with the patient's age (P = 0.006). In contrast, in cancerous tissues menopausal status had no influence on VEGF-A-expression levels. Benign and malignant tissues exhibited a similar expression pattern of VEGF-A-isoforms relative to each other. Thus, the regulation of the vasculature in normal breast tissue, as opposed to breast cancer tissue, appears to be hormonally dependent. Endogenous and therapeutically used hormonal steroids might, therefore, cause clinically relevant changes of the angiogenic phenotype of the human breast.

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“…Considering the menstrual cycle, other studies showed that the lowest BPE occurs during the second week of the cycle while the highest occurs during the first and fourth weeks (10,11). It is recommended to schedule non-urgent breast MRIs during days 3 -14 of the cycle to reduce diagnostic interference (7, 12).…”

Section: Discussionmentioning

confidence: 99%

Is Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging Associated with Breast Cancer?

et al. 2018

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Background: Background parenchymal enhancement (BPE) in breast magnetic resonance imaging (MRI) potentially correlates with breast cancer (BC). Thus, BPE may be used for BC risk stratification and for monitoring chemo-prevention. Objectives: We aimed to investigate the BPE patterns in benign and malignant breast lesions and in pre-menopausal and postmenopausal women. Methods: In 2017, 128 consecutive pre-menopausal or post-menopausal patients underwent breast MRI with different indications were examined. Subjects with the history of breast surgery, radiotherapy, or chemotherapy were excluded. A 1.5 Tesla device was used with the same protocol, and a blinded radiologist visually assessed and categorized breast BPE as minimal, mild, moderate, and marked. We used frequency distribution, mean, and standard deviation to report the findings. Comparing age or BPE in categorical variables, we appropriately used ANOVA, or Chi-square and Fisher's exact tests. Results:The mean (± standard deviation) age was 42.43 (± 10.82) years, and 89 (69.5%) patients were hormonally active. Eighteen (14.1%), 55 (43.0%), 41 (32.0%), and 14 (10.9%) patients were classified as having minimal, mild, moderate, and marked BPE, respectively. Age did not change among BPE levels (P = 0.197). Prevalence of moderate and marked BPE was higher in pre-menopausal women. BPE was not associated with breast lesion histopathology (P value = 0.857) in pre-menopausal or post-menopausal women (P = 0.790, and 0.840, respectively). Conclusions: BPE is a measure of breast tissue hormonal activity, and it is not correlated with histopathological diagnosis of breast lesion in both pre-menopausal and post-menopausal women. The data of this study do not support the use of BPE for BC risk estimation.

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Menstrual cycle and age: influence on parenchymal contrast medium enhancement in MR imaging of the breast.

Abstract: Patients showed statistically significantly lower parenchymal enhancement in menstrual cycle days 7-20 than in days 21-6. Patients aged 35-50 years yielded higher parenchymal enhancement than did younger patients and older patients.

Cited by 244 publications

References 0 publications

Magnetic resonance imaging features of fibrocystic change of the breast

Magnetic resonance imaging features of fibrocystic change of the breast

Vascular endothelial growth factor A (VEGF-A) mRNA expression levels decrease after menopause in normal breast tissue but not in breast cancer lesions

Is Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging Associated with Breast Cancer?

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