Magnetic resonance imaging in preoperative diagnosis of invasive lobular carcinomas of the breast – analysis of 230 cases
Authors:
O. Coufal 1
; M. Schneiderová 2; K. Petrakova 3; I. Babánková 4; I. Selingerová 5
Authors place of work:
Klinika operační onkologie, Masarykův onkologický ústav, Brno a LF Masarykovy univerzity, Brno
primář MUDr. V. Chrenko, CSc., přednosta: doc. MUDr. R. Šefr, Ph. D.
1; Oddělení radiologie, Masarykův onkologický ústav, Brno
primářka: MUDr. H. Bartoňková
2; Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno
přednosta: prof. MUDr. R. Vyzula, CSc.
3; Oddělení onkologické patologie, Masarykův onkologický ústav, Brno
primář: MUDr. P. Fabian, Ph. D.
4; Regionální centrum aplikované molekulární onkologie (RECAMO), Masarykův onkologický ústav, Brno
výkonný ředitel: doc. MUDr. D. Valík, Ph. D.
5
Published in the journal:
Rozhl. Chir., 2017, roč. 96, č. 8, s. 340-345.
Category:
Original articles
Summary
Introduction:
In breast cancer patients, magnetic resonance imaging (MRI) is a supportive method characterized by high sensitivity. Its indications in the preoperative assessment are not clearly defined. More likely to benefit from preoperative MRI are younger women, women with a dense breast on mammography and patients with invasive lobular carcinoma (ILC). The aim of this study was to assess utilization of MRI and resulting benefits in preoperative tumour staging of ILC in patients treated in our institution.
Methods:
A retrospective evaluation of medical records of all patients with bioptically proven and primarily surgically treated ILC through the years 2014−2016.
Results:
Overall, 230 patients were evaluated, among them 131 (57.0%) underwent MRI. These patients were significantly younger than patients without MRI. The results of MRI were as follows: in 28.2% a small unicentric lesion, in 41.2% large infiltration or multifocality, and in 30.5% suspicion of multicentricity. The proportion of conservative surgeries and re-resections did not differ between the patients with and without MRI. The subgroup of patients with a small unicentric lesion on MRI showed a higher proportion of conservative surgeries and fewer re-resections compared to the other subgroups. In 41 women (31.3%) the MRI finding resulted in further assessments; in 29 (22.1%) an additional biopsy was done, with a malignant result in the ipsilateral breast in 8 cases and in the contralateral breast in 3 cases. The MRI finding had a substantial impact on surgery in 35 patients (26.7%) of whom it was evaluated as clinically beneficial in 23 (65.7%) cases.
Conclusion:
At our institution, more than a half of patients with ILC undergo MRI preoperatively. The finding has an impact on the scope of the surgery in approximately one fourth of the cases, being clinically beneficial in most of them. However, a high frequency of additional imaging assessments and biopsies should be taken into account. Due to the low specificity of MRI, every suspicious lesion has to be bioptically verified to avoid inappropriate surgery and patient harm.
Key words:
breast cancer – invasive lobular carcinoma – magnetic resonance imaging – occult lesion – biopsy
Zdroje
1. Schneiderová M, Belanová R, Bartoňková H, et al. Magnetická rezonance prsu – první zkušenosti. Klinická onkologie 2006;19:3.
2. Mann RM, Hoogeven, YL, Blickman JG, et al. MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature. Breast Cancer Res Treat 2008;107:1−14.
3. Barco I, Chabrera C, García-Fernández A, et al. Magnetic resonance imaging in the preoperative setting for breast cancer patients with undetected additional disease. Eur J Radiol 2016;85:1786−93.
4. Parvaiz MA, Yang P, Razia E, et al. Breast MRI in invasive lobular carcinoma: A useful investigation in surgical planning? Breast J 2016;22:143−50.
5. Vos EL, Voogd AC, Verhoef C, et al. Benefits of preoperative MRI in breast cancer surgery studied in a large population-based cancer registry. Br J Surg 2015;102:1649−57.
6. Thompson A, Santucci G, Curcio M. The impact of preoperative magnetic resonance imaging in detecting additional disease in breast cancer patients. J Registry Manag 2016;43:87−9.
7. Bansal GJ, Santosh D, Davies EL. Selective magnetic resonance imaging (MRI) in invasive lobular breast cancer based on mammographic density: does it lead to an appropriate change in surgical treatment? Br J Radiol 2016;89:2−7.
8. Bae MS, Lee SH, Chu AJ, et al. Preoperative MR imaging in women with breast cancer detected at screening US. Radiology 2017;282:681−9.
9. Arpino G, Bardou VJ, Clark GM, et al. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res 2004;6:R149−56.
10. Nenutil R. Histologie a histopatologie In: Coufal O, Fait V, et al. Chirurgická léčba karcinomu prsu. 1st ed. Praha, Grada Publishing 2011:41−61.
11. Dušek L, Mužík J, Kubásek M, et al. Epidemiologie zhoubných nádorů v České republice. Portál SVOD. Available from: http://www.svod.cz/analyse.php?modul=vek.
12. Derias M, Subramanian A, Allan S, et al. The role of magnetic resonance imaging in the investigation and management of invasive lobular carcinoma – a 3-year retrospective study in two district general hospitals. Breast J 2016;22:384−9.
13. Houssami N, Ciatto S, Macaskill P, et al. Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer. J Clin Oncol 2008;26:3248−58.
14. Brennan ME, Houssami N, Lord S, et al. Magnetic resonance imaging screening of the contralateral breast in women with newly diagnosed breast cancer: systematic review and meta-analysis of incremental cancer detection and impact on surgical management. J Clin Oncol 2009;27:5640−9.
15. Turnbull LW, Brown SR, Olivier C, et al. Multicentre randomised controlled trial examining the cost-effectiveness of contrast-enhanced high field magnetic resonance imaging in women with primary breast cancer scheduled for wide local excision (COMICE). Health Technol Assess 2010;14:1−182.
16. Turnbull L, Brown S, Harvey I, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial. Lancet 2010;375:563−71.
17. Heil J, Bühler A, Golatta M, et al. Does a supplementary preoperative breast MRI in patients with invasive lobular breast cancer change primary and secondary surgical interventions? Ann Surg Oncol 2011;18:2143−9.
18. Plana MN, Carreira C, Muriel A, et al. Magnetic resonance imaging in the preoperative assessment of patients with primary breast cancer: systematic review of diagnostic accuracy and meta-analysis. Eur Radiol 2012;22:26−38.
19. Mukherjee SD, Hodgson N, Lovrics PJ, et al. A retrospective study evaluating the impact of preoperative breast MRI on surgical decision-making in young patients. Breast Cancer (Auckl) 2016;10:53–60.
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