Type:
Educational Exhibit
Keywords:
Pathology, Neoplasia, Cancer, Education, Diagnostic procedure, Comparative studies, Ultrasound, MR, Mammography, Oncology, Management, Breast
Authors:
N. Rotaru, I. Gavrilasenco; Chisinau/MD
DOI:
10.1594/ecr2013/C-2223
Imaging findings OR Procedure details
The most successful protocol in MRM that permits differentiation of malignant from benign lesions combines two techniques: surface coils for adequate spatial resolution,
and dynamic contrast enhancement studies.MRM was performed in women with suspicious or equivocal results in conventional mammography and ultrasonography because of either dense parenchyma or heterogeneous echogenicity with dorsal shadowing with a purpose to exclude multifocal disease or contralateral breast cancer.All lesions were analyzed regarding their qualitative characteristics.
The sensitivity of MRM was significantly higher compared to mammography and sonography (p< 0.005 and p<0.05,
respectively; Table 3).
The specificity of sonography was significantly higher than those of mammography and MRM (p<0.05 and p<0.005,
respectively; Table 3).The positive predictive value (PPV) of MRM was much higher than mammography and sonography (p<0.005; Table 3).
The negative predictive values for sonography and MRM were significantly higher than that of mammography (p< 0.05 and p<0.005,
respectively; Table 3).
With regard to accuracy,
no significant differences between the 3 imaging methods were found (Table 3).
Combination of all 3 diagnostic methods (MRM,
mammography and sonography) yielded the best result for cancer detection (PPV=95.3%,
p<0.005).
In case of detection multifocal or multicentric disease it was applied mastectomy + axillary clearance + chemotherapy and/ or radiotherapy pre- and post surgery,
at an one-focal tumours (T1-2) – tumorectomie ± axillary clearance (depending on involving in malignant pathological process of regional lymph nodes) + chemotherapy and/ or radiotherapy post surgery.
The present TNM staging system takes into consideration tumor size,
nodal involvement,
and metastases.
MRM is able to improve the determination of tumor size and degree extension over presently used techniques.
It is now more critical to know the size and disease extent within the breast,
whether it invades adjacent tissues,
and if multicentric disease is present.
Tumor size and extent primarily influences the choice of local treatment.
Palpation was incorrect in 25% and mammography was incorrect in 10%.
MRM is more accurate for measuring breast cancer size.
Since MRM can acquire data in a volumetric method,
it should be able to obtain even more accurate tumor volume measurements based on 3-dimensional depiction of the frequently irregular tumors