scholarly journals Surgical attitudes toward preoperative breast magnetic resonance imaging in women with early-stage breast cancer

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
S. D. Mukherjee ◽  
N. Hodgson ◽  
P. J. Lovrics ◽  
K. Dhamanaskar ◽  
S. Chambers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Magnetic Resonance Imaging ◽  
Early Stage ◽  
Breast Mri ◽  
Early Stage Breast Cancer ◽  
Published Data ◽  
Resonance Imaging ◽  
Breast Magnetic Resonance

Background Preoperative breast magnetic resonance imaging (mri) is commonly requested by surgeons in the initial workup of women with breast cancer; however, its use is controversial. We performed a survey of breast cancer surgeons across Canada to investigate current knowledge about, attitudes to, and self-reported use of preoperative breast mri in a publicly funded health care system in light of the limited evidence to support it.Methods All identified general surgeons in Canada were mailed a survey instrument designed to probe current practice and knowledge of published trials.Results Of 403 responding surgeons, 233 (58%) indicated that they performed breast cancer surgery. Of those 233, 218 (94%) had access to breast mri and completed the entire survey. Overall, 54.6% of responding surgeons felt that breast mri was useful in surgical planning, and more than half (58.3%) indicated that their frequency of use was likely to increase over the next 5 years. Surgeons found preoperative mri most useful in detecting mammographically occult disease (71.5% of respondents) and in planning for breast-conserving surgery (57.3%). The main limitations reported were timely access to mri (51%) and false positives (36.7%). Responses suggest a knowledge gap in awareness of published trials in breast mri.Conclusions Our study found that, in early-stage breast cancer, self-reported use of mri by breast cancer surgeons in Canada varied widely. Reported indications did not align with published data, and significant gaps in self-reported knowledge of the data were evident. Our results would support the development and dissemination of guidelines to optimize use of mri.

Breast Magnetic Resonance Imaging in Early-Stage Breast Cancer: Is There Really No Value?

2008 ◽  
Vol 26 (20) ◽  
pp. 3465-3466 ◽  
Author(s):  
Nicky H.G.M. Peters ◽  
Maurice A.A.J. van den Bosch ◽  
Petra H.M. Peeters ◽  
Willem M.P.Th. Mali ◽  
Inne H.M. Borel Rinkes
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
No Value ◽  
Breast Magnetic Resonance Imaging ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Resonance Imaging ◽  
Breast Magnetic Resonance

scholarly journals Indications for breast magnetic resonance imaging at a referral center for the diagnosis and treatment of breast cancer in Brazil

2021 ◽  
Vol 54 (2) ◽  
pp. 83-86
Author(s):  
Samuel Silva Ferreira ◽  
Adriene Moraes Campos ◽  
Patrícia Lima Fernandes ◽  
Izabela Machado Pereira ◽  
Flavia Maria Rodrigues ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
High Risk ◽  
Magnetic Resonance ◽  
Breast Magnetic Resonance Imaging ◽  
Breast Mri ◽  
Diagnosis And Treatment ◽  
Resonance Imaging ◽  
Referral Center ◽  
Breast Magnetic Resonance

Abstract Objective: To describe the indications for breast magnetic resonance imaging (MRI) at a referral center for breast cancer in Brazil. Materials and Methods: This was a retrospective study in which we reviewed the clinical records, including physician requests and patient questionnaires, of women who underwent breast MRI between 2014 and 2018 at a referral center for the diagnosis and treatment of breast cancer in the city of Belo Horizonte, Brazil. Results: The most common indication for breast MRI was as a complement to mammography/ultrasonography (in 43.6% of cases), followed by breast cancer staging (in 25.1%), the screening of patients at high risk (in 17.4%), the evaluation of breast implants (in 10.1%), and the evaluation of the response to neoadjuvant chemotherapy (in 3.8%). Conclusion: Although there is strong evidence supporting the use of breast MRI, mainly for the screening of high-risk patients, the imaging method is underutilized in Brazil.

scholarly journals Breast Magnetic Resonance Imaging of Multicentric, Multifocal and Bilateral Cancer — A Case-based Review

2011 ◽  
Vol 07 (01) ◽  
pp. 24
Author(s):  
Virginia Pérez Dueñas ◽  
María Ruíz de Gopegui Andreu ◽  
Sara Morón Hodge ◽  
Asunción Suárez Manrique ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
False Positive ◽  
Breast Magnetic Resonance Imaging ◽  
Breast Mri ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Mri Features ◽  
Breast Magnetic Resonance

Multifocal or multicentric breast cancer can be difficult to detect on mammography or ultrasound, particularly in patients with dense breast tissue. A multimodality approach that includes breast magnetic resonance imaging (MRI) is indicated, particularly when conservative surgery is being considered as it is the most sensitive technique for identifying additional sites of disease. However, its influence on recurrence and survival rates has yet not been clearly established, and false-positive cases may lead to more aggressive management and treatment. Radiologists should therefore be aware of relevant breast MRI findings. Infiltrating carcinomas, contralateral unsuspected carcinomas, occult carcinomas, false-positive cases and post-chemotherapy changes. Several cases of multiple-site breast carcinomas and their corresponding mammographic, ultrasound and MRI features have been reviewed for this article, in which the definition and differences between multifocal, multicentric and contralateral breast carcinoma are explained and the most relevant imaging findings on MRI are illustrated and correlated with mammogram and ultrasound findings. Finally, the role of breast MRI in the pre-operative assessment of breast cancer is discussed.

scholarly journals The Role of Preoperative Bilateral Breast Magnetic Resonance Imaging in Patient Selection for Partial Breast Irradiation in Ductal CarcinomaIn Situ

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Kristin V. Kowalchik ◽  
Laura A. Vallow ◽  
Michelle McDonough ◽  
Colleen S. Thomas ◽  
Michael G. Heckman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Magnetic Resonance Imaging ◽  
Breast Mri ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Resonance Imaging ◽  
Ipsilateral Breast ◽  
Breast Magnetic Resonance

Purpose. Women with ductal carcinomain situ(DCIS) are often candidates for breast-conserving therapy, and one option for radiation treatment is partial breast irradiation (PBI). This study evaluates the use of preoperative breast magnetic resonance imaging (MRI) for PBI selection in DCIS patients.Methods. Between 2002 and 2009, 136 women with newly diagnosed DCIS underwent a preoperative bilateral breast MRI at Mayo Clinic in Florida. One hundred seventeen women were deemed eligible for PBI by the NSABP B-39 (National Surgical Adjuvant Breast and Bowel Project, Protocol B-39) inclusion criteria using physical examination, mammogram, and/or ultrasound. MRIs were reviewed for their impact on patient eligibility, and findings were pathologically confirmed.Results. Of the 117 patients, 23 (20%) were found ineligible because of pathologically proven MRI findings. MRI detected additional ipsilateral breast cancer in 21 (18%) patients. Of these women, 15 (13%) had more extensive disease than originally noted before MRI, and 6 (5%) had multicentric disease in the ipsilateral breast. In addition, contralateral breast cancer was detected in 4 (4%).Conclusions. Preoperative breast MRI altered the PBI recommendations for 20% of women. Bilateral breast MRI should be an integral part of the preoperative evaluation of all patients with DCIS being considered for PBI.

Preoperative Breast Magnetic Resonance Imaging: Applications in Clinical Practice

2012 ◽  
Vol 63 (3) ◽  
pp. 207-214 ◽  
Author(s):  
Supriya Kulkarni ◽  
Nitin Singh ◽  
Pavel Crystal
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Magnetic Resonance Imaging ◽  
Early Stage ◽  
Survival Rates ◽  
Radical Mastectomy ◽  
Breast Conserving Surgery ◽  
Resonance Imaging ◽  
Breast Magnetic Resonance

Results of large randomized trials have shown that survival rates after breast conserving surgery are equivalent to those obtained by radical mastectomy. Breast conserving surgery with wide local excision in women with early stage breast cancer who are thought to have a single and resectable tumour as determined by clinical examination and conventional imaging followed by postoperative irradiation is the standard of care in early breast cancer. Mapping of local disease is the key element to guide optimal surgery to obtain tumour-free margins, thereby decreasing risk of local recurrence. The usual preoperative workup of breast malignancy consists of clinical breast examination and mammography with or without ultrasound. However, mammography and ultrasound fail to accurately assess tumour extent in as many as a third of patients eligible for breast conserving therapy. It is well established that magnetic resonance imaging is far superior to mammography (with and without ultrasound) for mapping the local extent of breast cancer. Experts advocate its use despite its high costs, high number of false positive findings, and lack of evidence from randomized prospective trials and, notably, fear of “overtreatment.” This article discusses the current role of breast magnetic resonance imaging with its clinical advantages and applications.

Preoperative Breast Magnetic Resonance Imaging: Controversies Arising in the Quest to Evaluate Clinical Benefit

2011 ◽  
Vol 62 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Petrina A. Causer
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Clinical Benefit ◽  
Breast Magnetic Resonance Imaging ◽  
Breast Mri ◽  
Resonance Imaging ◽  
Detection Rates ◽  
Breast Magnetic Resonance

Breast magnetic resonance imaging (MRI) is indisputably the highest sensitivity test available to detect breast cancer, revealing more extensive cancer in the ipsilateral and otherwise occult cancer in the contralateral breasts when used before surgery. The use of preoperative breast MRI has become somewhat controversial, because the clinical benefit of the heightened detection provided by MRI has been questioned in the context of multidisciplinary breast cancer treatment, relatively low local recurrence, and metachronous contralateral cancer rates. Also, MRI detection rates have been compared with the high rates reported in the pathology literature. The emerging clinical outcome literature is showing conflicting results to demonstrating actual overall benefit. Critical review of this literature reveals several misconceptions about MRI detection rates and limitations of many of the published outcome studies to date, which render the results not necessarily generalizable to contemporary optimized breast MRI practices. This article addresses some of the misconceptions raised by critics, provides a critical review of the clinical outcome literature, reviews patient subgroups anticipated to have the highest yield when using preoperative MRI, makes recommendations for optimizing breast MRI practice, and suggests areas for potential future research.

Effect of Breast Magnetic Resonance Imaging on the Clinical Management of Women With Early-Stage Breast Carcinoma

2002 ◽  
Vol 20 (16) ◽  
pp. 3413-3423 ◽  
Author(s):  
Gayle F. Tillman ◽  
Susan G. Orel ◽  
Mitchell D. Schnall ◽  
Delray J. Schultz ◽  
Jacqueline E. Tan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Management ◽  
Breast Magnetic Resonance Imaging ◽  
Early Stage ◽  
Breast Mri ◽  
Early Stage Breast Cancer ◽  
Favorable Effect ◽  
Resonance Imaging ◽  
Unfavorable Effect ◽  
Breast Magnetic Resonance

PURPOSE: To determine the impact of breast magnetic resonance imaging (MRI) on the clinical management of patients with early-stage breast cancer. PATIENTS AND METHODS: A review was performed of the records of 207 women with early-stage breast cancer (including five women with bilateral disease) who underwent breast MRI during work-up for breast conservation treatment. All patients presented with clinical stage 0, I, or II disease. For each patient, a determination was made whether the breast MRI affected the clinical management, and if so, whether the patient was well served by the change in management. RESULTS: The MRI findings affected the clinical management in 43 cases (20% of 212 breast cancers). Based on the pathology findings and the overall clinical course for each case, the breast MRI was judged to have had a strongly favorable effect on management in 18 cases (8%), a somewhat favorable effect in six cases (3%), an uncertain effect in five cases (2%), a somewhat unfavorable effect in 11 cases (5%), and a strongly unfavorable effect in three cases (1%). The effect of MRI was not significantly different for invasive carcinoma compared with ductal carcinoma-in-situ (all P ≥ .27). However, the effect of MRI was significantly greater when the MRI was performed before an excisional biopsy (P = .0011) or for larger tumors (P = .0089). CONCLUSIONS: Breast MRI alters the clinical management for a sizable fraction of women with early-stage breast cancer and appears to offer clinically useful information for determining optimal local treatment.

Prospective Study of the Efficacy of Breast Magnetic Resonance Imaging and Mammographic Screening in Survivors of Hodgkin Lymphoma

2013 ◽  
Vol 31 (18) ◽  
pp. 2282-2288 ◽  
Author(s):  
Andrea K. Ng ◽  
Judy E. Garber ◽  
Lisa R. Diller ◽  
Robyn L. Birdwell ◽  
Yang Feng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Hodgkin Lymphoma ◽  
Breast Magnetic Resonance Imaging ◽  
Breast Mri ◽  
Resonance Imaging ◽  
Breast Magnetic Resonance ◽  
Chest Irradiation ◽  
Female Cancer Survivors

Purpose Current guidelines recommend breast magnetic resonance imaging (MRI) as an adjunct to mammography for breast cancer screening in female cancer survivors treated with chest irradiation at a young age, beginning 8 to 10 years after treatment. Prospective data evaluating its efficacy in female cancer survivors are lacking. This study sought to compare the sensitivity and specificity of breast MRI with those of mammography in women who received chest irradiation for Hodgkin lymphoma (HL). Patients and Methods We enrolled 148 women treated with chest irradiation for HL at age ≤ 35 years who were > 8 years beyond treatment. Yearly breast MRI and mammogram were performed over a 3-year period. Sensitivity and specificity of the two screening modalities were compared. Results With the screening, 63 biopsies were performed in 45 women; 18 (29%) showed a malignancy. All but one of the screen-detected malignancies were preinvasive or subcentimeter node-negative breast cancers. After excluding first-screen MRI and mammogram, mammogram sensitivity was 68% as compared with 67% for MRI (P = 1.0). Sensitivity increased to 94% using both screening modalities. The specificities of mammogram alone, MRI alone, and both were 93%, 94%, and 90%, respectively. Conclusion In contrast to women with genetic or familial risk, in HL survivors breast MRI was not more sensitive than mammogram for breast cancer detection. However, the two screening modalities complement each other in the detection of early cases of disease. Early diagnosis is particularly important in these patients, given the breast cancer treatment challenges in patients who have received prior cancer therapy.

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