MRI detection of distinct incidental cancer in women with primary breast cancer studied in IBMC 6883

被引:120
作者
Schnall, MD
Blume, J
Bluemke, DA
Deangelis, GA
Debruhl, N
Harms, S
Heywang-Köbrunner, SH
Hylton, N
Kuhl, CK
Pisano, ED
Causer, P
Schnitt, SJ
Smazal, SF
Stelling, CB
Lehman, C
Weatherall, PT
Gatsonis, CA
机构
[1] Univ Penn, Dept Radiol, Philadelphia, PA 19104 USA
[2] Brown Univ, Ctr Stat Sci, Providence, RI 02912 USA
[3] Johns Hopkins Univ, Russell H Morgan Dept Radiol & Radiol Sci, Sch Med, Baltimore, MD USA
[4] Univ Virginia Hlth Syst, Dept Radiol, Charlottesville, VA USA
[5] Univ Calif Los Angeles, Sch Med, Dept Radiol Sci, Los Angeles, CA 90024 USA
[6] Univ Arkansas, Sch Med Sci, Dept Radiol, Little Rock, AR 72204 USA
[7] Tech Univ Munich, Rechts Isar Hosp, Inst Radiol, D-8000 Munich, Germany
[8] Univ Calif San Francisco, Dept Radiol, Magnet Resonance Sci Ctr, San Francisco, CA 94143 USA
[9] Univ Bonn, Dept Radiol, D-5300 Bonn, Germany
[10] Univ N Carolina, Dept Radiol, Chapel Hill, NC USA
[11] Univ Toronto, Sunnybrook Canc Care Ctr, Toronto, ON, Canada
[12] Beth Israel Deaconess Med Ctr, Dept Pathol, Boston, MA 02215 USA
[13] Harvard Univ, Sch Med, Boston, MA 02115 USA
[14] Porter Adventist Hosp, Radiol Imaging Associates, Denver, CO USA
[15] Univ Texas, MD Anderson Canc Ctr, Div Diagnost Imaging, Houston, TX 77030 USA
[16] Univ Washington, Dept Radiol, Seattle, WA 98195 USA
[17] Univ Texas, SW Med Ctr, Dept Radiol, Dallas, TX 75230 USA
[18] Brown Univ, Ctr Stat Sci, Providence, RI 02912 USA
关键词
breast cancer; MRI; staging;
D O I
10.1002/jso.20381
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Prior single institution studies suggest MRI may improve the assessment of the extent of cancer within the breast, and thus reduce the risk of leaving macroscopic disease in the breast following breast conservation therapy. We report on the rate of MRI and mammography detection of foci of distinct incidental cancer in a prospective, multi center trial involving 426 women with confirmed breast cancer at 15 institutions in the US, Canada, and Germany. Methods: Women underwent mammography and MRI prior to biopsy of the suspicious index lesion. Additional incidental lesions (IL) greater than 2 cm from the index lesion that were detected by mammography and MRI were noted and characterized. Biopsy recommendations were associated with ILs given an assessment of suspicious or highly suspicous (BiRads 4 and 5). These assessments were considered a positive test. Results: MRI had a significantly higher yield of confirmed cancer ILs than mammography (0.18 (95%CI: 0.142-0.214) for MRI versus 0.072 (95%CI: 0.0500.100) for mammography). The cancer ILs detected by MRI alone appeared to be similar to those detected by mammography with respect to size and histology. The percentage of biopsies of ILs that resulted in a cancer diagnosis was similar between the modalities (MRI 0.72(95%Cl: 0.6-0.81); Mammography 0.85 (95%CI: 0.62-0.96)). Conclusions: These results suggest that consideration needs to be given regarding the integration of breast MRI into the pretreatment evaluation of women seeking breast conservation therapy.
引用
收藏
页码:32 / 38
页数:7
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