MRI before initial surgery outside of clinical trials: the real world!

Cortesi, Laura; Matteis, Elisabetta De; Crimi, Claudia; Filieri, Elisabetta; Pecchi, Annarita; Battista, Rachele; Canossi, Barbara; Torricelli, Pietro; Federico, Massimo

doi:10.1016/s0720-048x(12)70009-8

Cited by 2 publications

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“…Interestingly, tumor size has been increasing over the last two decade, probably due to the improvements in radiological techniques. At the beginning of nineties, most of de novo metastatic patients were only clinically examined, whereas recently other techniques, including breast MRI, are routinely used to better define the real extension of the disease . An improvement in radiological investigations could also explain the significant reduction of single metastatic sites at the diagnosis observed in the last period.…”

Section: Discussionmentioning

confidence: 99%

“…At the beginning of nineties, most of de novo metastatic patients were only clinically examined, whereas recently other techniques, including breast MRI, are routinely used to better define the real extension of the disease. [14][15][16] An improvement in radiological investigations could also explain the significant reduction of single metastatic sites at the diagnosis observed in the last period. In fact, in the period 2006-2009, about 45% of metastases were more likely to be multiple, probably due to a better study of the disease since the diagnosis with CT or PET scan.…”

Section: Discussionmentioning

confidence: 99%

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Twenty-years experience withde novometastatic breast cancer

et al. 2015

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Although new treatments have been widely studied to improve the survival of patients with metastatic breast cancer (BC), prognosis continues to be poor with an average survival time no longer than 3 years. We carried on a population-based study with the purpose of evaluating the outcome of metastatic breast cancer in the province of Modena from 1990 to 2009. We examined the Modena Cancer Registry and evaluated the 5-year overall survival (OS) of women diagnosed with a de novo metastatic breast cancer between 1990 and 2009, defining 5 periods of 4 years each. After a median followup time of 29 months, the 5-year OS was 11% for years 1990-1993, 15% for years 1994-1997, 12% for years 1998-2001, 20% for years 2002-2005 and 29% for years 2006-2009 (p 5 0.012). Overall, although no OS differences were noted in the first decade analyzed, a real advantage has been shown in the last two cohorts. In a multivariate analysis, the 5-year OS was significantly increased only for hormone receptor positive and HER21 tumors, whereas chemotherapy treatments were not significant independent predictors of survival in "de novo" metastatic BC (p 5 0.08). Our analysis confirms that the prognosis of de novo metastatic breast cancer has improved overtime, particularly in the last decade. Trastuzumab, LH-RH analogues and aromatase inhibitors have determined a significant clinical benefit and costeffectiveness in metastatic breast cancer treatment.Breast cancer (BC) continues to be the most common form of cancer that affects women, but currently is no longer the leading cause of cancer deaths. However, the prognosis of patients with metastatic disease continues to be poor, with an average survival time no longer than 3 years.1,2 Although clinical trials suggest that early detection strategies and advances in adjuvant therapy are improving outcomes, it is unclear if this may affect patterns of relapse and 20-30% of patients with early BC will eventually develop relapse with distant metastatic disease. Therefore, distant recurrence remains common and incurable and, currently, the principal goal of treatment for women with metastatic disease is to improve quality of life and to prolong survival. 3,4 Although new treatments have been widely investigated in the metastatic setting, it is not clear whether the overall outcome has improved. Particularly, Seruga et al.5 observed no significant change in outcome or in absolute benefit of experimental therapies in Phase III randomized clinical trials evaluating treatment for metastatic BC. Moreover, the costs of experimental medical therapies approved for metastatic disease increase [mt]100-fold each month, without any gain in the absolute benefit. Therefore, Seruga et al.5 demonstrated that new and expensive treatments of metastatic BC lead to unchanging levels of benefit and rapidly increasing costs, concluding that new therapies are becoming much less costeffective. Moreover, Galy et al.6 performed a retrospective study to examine temporal trends in the use of chemotherapeutic agents for the treat...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Twenty-years experience withde novometastatic breast cancer

et al. 2015

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“…In 2012 (7) study, 75% of the patients treated with mastectomy after MRI for so In 2003 (8) (6) study, 58%…”

Section: Inmentioning

confidence: 99%

The Role of MRI in Diagnosis and Management of Breast Cancer during Fertility Period

Ahmed

2021

Benha Medical Journal

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Background: Breast MRI is no longer considered as an experimental modality, but has reached a solid position in the diagnosis and workup of breast lesions. Aim:is to assess the impact of contrast enhanced MRI in the diagnosis and management of breast cancer in young female patients. Patients & methods: Retrospective descriptive study of imaging findings of pathologically proved breast cancer in young female patients, from Kasr Al Ainy hospital, National cancer institute and El Sahel teaching hospital. From Jan.2018 to June 2018.The patients were referred from general surgery department. Approval of the local ethical committee were taken in consideration. Economic status of the patients have been considered.25 patients, Ages ranged between 20 and 40 years (mean age 30); the previous ultrasound and mammography scans done for the patients to assess the actual size, metabolic behaviour of the lesion and its relation to the surrounding structures. Results: The current study showed that 18/25(72%) cases had multicentric breast cancer and 7/25 (28%) cases had single masses. 21/25 (84%) cases were missed by mammography. 14/25 (56%) cases were missed by ultrasound. Conclusion: We concluded that DCE-MRI has a vital role in the diagnostic work up and management of breast cancer in young women. MRI revealed most specific criteria for malignancy and it has a great ability to detect both of main lesion and additional lesions(multicentric malignancy).MRI is a very important modality as it can assist in management by more accurate assessment of the extent of disease.

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MRI before initial surgery outside of clinical trials: the real world!

Cited by 2 publications

References 14 publications

Twenty-years experience withde novometastatic breast cancer

Twenty-years experience withde novometastatic breast cancer

The Role of MRI in Diagnosis and Management of Breast Cancer during Fertility Period

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