118 patients were studied with one complete diagnostic round (MX,
US,
MR),
81 with two complete rounds,
56 with three rounds and 24 with four rounds.
Of the 118 patients undergoing MRI surveillance,
7 had breast cancer [Table 2].
In particular 4 breast cancer were detected with all three imaging techniques [Fig.
5,
Fig.
6,
Fig.
7]; 1 lesion was visible only at MRI [Fig.
1,
Fig.
2,
Fig.
3] and 1 only at US examination [Fig.
4].
1 breast cancer was detected in another medical center,
where the patient underwent only breast ultrasound.
Mammography detected 4/6 lesions (67%),
US and MRI detected 5/6 lesions (83%).
In one patient with all techniques positive,
mammography and US showed one neoplastic lesion,
MRI showed multicentric cancer with “non mass like enhancement”; mastectomy confirmed multicentric CDIS.
Breast cancer visible only at US examination had 5 mm diameter and was located at upper-external quadrant in the marginal portion of the breast,
partial hidden by artifact movements at MRI [Fig.
4].
At critical revision of previous MRI round,
6/7 breast cancer were visible as non specific enhancement focus with diameter of 3-5 mm [Fig.
7].
The second look ultrasound performed after first MR examination were 6/118,
one of which for breast cancer.
After second round with MR we performed 1/81 US second look; after the third MR round 3/56 US second look,
two of which in patient with brast cancer and 0/24 after the fourth MR round.
The false positive results histologically evaluated were 2 for MX,
2 for US and 4 for MR.
The sensitivity and specificity of different imaging techniques were:
- MX: 67% 99%
- US: 83% 99%
- RM: 83% 98%