Type:
Educational Exhibit
Keywords:
Cancer, Technical aspects, Surgery, MR, Mammography, Breast
Authors:
C. BALLANO FRANCO, O. Bueno Zamora, C. Malfaz Barriga, A. Fernández Gonzalo, C. Odene Cantero, F. J. Olcoz Monreal, E. García Laborda; Madrid/ES
DOI:
10.1594/ecr2018/C-1536
Findings and procedure details
A retrospective database search in a single institution identified 53 patients with CDIS breast cancer diagnosed the last fouryears,
who underwent breast MRI before surgery.
These patients had no personal history of invasive breast cancer or local surgery.
All subjects were imaged using a 1.5TMR equipment,
and sequences performed were a T2 with fat suppression,
T1 THRIVE poscontrast,
digital subtraction,
and curves of dynamic contrast-enhanced.
MRI detected previously unsuspected lesions in 16 patients (30.1 %).
11 of these lesions (20 % of patients) were identified as malignant and 5 as benign (Figure 7).
In 2 patients,
contralateral DCIS was diagnosticated (3.7%)(Figure 5).
Unsuspected multicentricity was found in 10 patients (18.8 %) (Figure 4),
and a significance (>1 cm) increase in tumor sizein 9 patients (16.9 %).
Ganglionar affectation was identified in 3 patients (5.6%) (Figure 6).
A total of 4 women were reclassified in invasive cancer after MR study (3 had ganglionar affectation and 1 presented a malignant unsuspected invasive lesion).
These additional information led to more extended surgery in 21 patients (39.6%),
adding up those with multicentricity,
lesions with significant increase,
a new invasive lesion (1 case),
cutaneous affectation (1 case)(Figure 8) and ganglionar extension (3 cases).
A total of 25 mastectomies were the selected treatment (47.1%).
As patients can choose mastectomy for personal election,
a limitation of this study is that we were unable to know how many of them were indicated by the MR results.
To calculate this percent,
comparation whit DCIS treatment without preoperative MR should be done.
Three additional unsuspected hepatic lesions was identified (5.6%),
and comparing with previous CT studies were classified as benign lesions (Figure 9).