Präoperative MR-Mammographie bei bekanntem Mammakarzinom. Sinnvolle Mehrinformation oder sinnloser Mehraufwand?

Abstract

In a retrospective study the value of MR mammography in cases of radiological well-known carcinoma of the breast was evaluated preoperatively in 76 cases of histopathologically verified carcinoma one lesion was missed by MR imaging. Compared to the results of conventional X-ray mammography additional malignant lesions were detected in 5 patients ipsilaterally and in another 8 patients contralaterally by MR mammography only. In additional 4 cases MR mammography demonstrated suspicious lesions contralaterally, but histopathology revealed benign lesions. The therapeutic procedure was changed in 15 cases (18.5%) due to the findings of MR imaging: Ipsilateral mastectomy instead of tumorectomy (n = 5) or primary chemotherapy instead of operation (n = 1); contralateral additional tumorectomy (n = 3) or mastectomy (n = 2) by carcinoma and open biopsy (n = 4) by benign finding.

Breast MR Imaging Screening in 192 Women Proved or Suspected to Be Carriers of a Breast Cancer Susceptibility Gene: Preliminary Results

“…In our view, this is the most important finding of this preliminary study: While the very high sensitivity of breast MR concerning the detection of breast cancer is well recognized (27)(28)(29)32), the modality's limited specificity and, notably, its allegedly high number of false-positive findings have led to the estimation that breast MR may not be suitable for screening.…”

“…Magnetic resonance (MR) imaging of the breast has been shown to be sensitive for invasive breast cancer (26)(27)(28)(29)(30)(31)(32)(33); its sensitivity is not impaired by dense parenchyma. In addition, MR imaging is not associated with ionizing radiation.…”

The Value of Magnetic Resonance Imaging for Staging and Breast Conserving Surgery Planning

“…The high sensitivity of MRI has proven useful in the detection of multifocal lesions and contralateral carcinomas [8,9] . According to Mumtaz et al, MRI provides more accurate findings regarding tumor size than either conventional MMG or USG [16] .…”

“…Its limitations include its moderate sensitivity in the diagnosis of in situ carcinomas and its low specificity [6,7] . The high sensitivity of MRI has proven useful in the detection of multifocal lesions and contralateral carcinomas [8][9][10] . MRI has been increasingly used in the preoperative evaluation of both the ipsilateral and contralateral breast in patients newly diagnosed with breast cancer [11][12][13] .…”

Präoperative MR-Mammographie beim Mammacarcinom Einfluß auf die operative Behandlung aus chirurgischer Sicht

“…Wurde die dynamische MRM nach ihrer Einführung durch Heywang und Kaiser [12,18] zunächst vielfach ungezielt eingesetzt, so bestehen mittlerweile nach erheblicher Verbesserung von Methodik und Technik klare Indikationen für den klinischen Einsatz [9,12]. Aufgrund unserer dargestellten Daten und der Literatur ergeben sich gegenwärtig folgende Indikationen für die sinnvolle Durchführung einer MRM: · Präoperativ erlaubt das MR-Verfahren vor geplanter brusterhaltender Therapie Aussagen zur Tumorausdehnung, zur Multifocalität sowie einem eventuellen multizentrischen Tumorgeschehen.…”