The usefulness of preoperative MRI in synchronous bilateral breast cancer

Y. Kosaka, Mariko Kikuchi, Norihiko Sengoku, Y. Tanaka, Mina Waraya, H. Katoh, K. Yamashita, Sabine Kajita, R. Woodhams, M. Watanabe
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引用次数: 2

Abstract

Background: The incidence of synchronous bilateral breast cancer is increasing each year. The applicability of contrast-enhanced magnetic resonance imaging (MRI) in the detection of multiple breast lesions has been reported in many studies. However, there have been no reports concerning the usefulness of preoperative MRI to evaluate synchronous bilateral breast cancer in Japan. We reviewed patients with synchronous bilateral breast cancer to investigate the applicability of contrastenhanced MRI in detecting contralateral breast cancer that was not visible by MMG or ultrasound. Methods: Synchronous bilateral breast cancer was found in 47 (3.2%) of the 1465 breast cancer patients who underwent surgery in our hospital between April 2006 and December 2012. Of those 47 patients, we enrolled 28 patients whose second lesions were non-palpable. The sensitivities of MMG, ultrasonography, and contrastenhanced MRI were compared for their ability to detect the malignancy of the second lesion. We also assessed the pathological characteristics of those lesions that were only visible by contrast-enhanced MRI. Results: In 28 patients whose second lesions were non-palpable,7% was DCIS in first lesions, and 39% was DCIS in second lesions. The median size of the invasive cancer was 2.3 cm (range, 0.5-9.5 cm) within the first lesions. The median size of the invasive cancer was 1.0 cm (range, 0.4-5.0 cm) within the second lesions. Of the 28 malignant lesions, 13 (46%) were positive by MMG, 18 (64%) were positive by ultrasonography, and 28 (100%) were positive by contrast-enhanced MRI. In six of the 28 patients (21%), the malignant lesions were found by contrast-enhanced MRI but not by MMG nor by ultrasonography. Conclusion: Contrast-enhanced MRI has the highest sensitivity and is therefore the most useful modality in identifying non-palpable breast abnormalities. It is especially useful in the detection of small contralateral lesions and lesions immediately under the nipple of the contralateral breast. Correspondence to: Yoshimasa Kosaka, Department of Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan; Tel: +81 427788111, Fax: +81 427789556; E-mail: y-kosaka@med.kitasato-u.ac.jp
同时性双侧乳腺癌术前MRI检查的价值
背景:双侧乳腺癌的发病率逐年上升。许多研究报道了对比增强磁共振成像(MRI)在乳腺多发病变检测中的适用性。然而,在日本还没有关于术前MRI评估同步双侧乳腺癌有效性的报道。我们回顾了同步双侧乳腺癌患者,探讨对比增强MRI在检测MMG或超声未见的对侧乳腺癌中的适用性。方法:2006年4月至2012年12月我院收治的1465例乳腺癌患者中,发现双侧同步乳腺癌47例(3.2%)。在这47例患者中,我们招募了28例第二病变不可触及的患者。比较MMG、超声检查和MRI增强检查对第二病变的敏感性。我们还评估了那些仅通过增强MRI可见的病变的病理特征。结果:28例第二病变不可触及的患者中,7%为第一病变DCIS, 39%为第二病变DCIS。浸润性癌的中位尺寸为2.3 cm(范围0.5-9.5 cm)。浸润性肿瘤的中位尺寸为1.0 cm(范围0.4-5.0 cm)。28例恶性病灶中MMG阳性13例(46%),超声检查阳性18例(64%),MRI增强检查阳性28例(100%)。在28例患者中,有6例(21%)的恶性病变是通过磁共振造影发现的,而不是通过MMG或超声检查发现的。结论:对比增强MRI具有最高的敏感性,因此是识别不可触及的乳房异常的最有用的方式。它在检测小的对侧病变和对侧乳房乳头下的病变时特别有用。通讯对象:日本神奈川县相模原市南区北中1-15-1北中大学医学院外科学科小坂良正;电话:+81 427788111,传真:+81 427789556;电子邮件:y-kosaka@med.kitasato-u.ac.jp
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