Breast Magnetic Resonance Imaging in the Management of Early Breast Cancer: Implications for Partial Breast Irradiation

Tendulkar, Rahul D.; Rybicki, Lisa; Rim, Alice; Chellman-Jeffers, Melanie; Macklis, Roger M.; Obi, B.B.

doi:10.1016/j.ijrobp.2007.07.043

Cited by 11 publications

(26 citation statements)

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“…Previous published reports have shown a change of 2% to 10% in PBI recommendations for patients with a diagnosis of multicentric disease after breast MRI (13)(14)(15)(16)(17)(18). Multifocality has also been evaluated, with a finding of a 4% to 9% change in PBI recommendations (13)(14)(15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

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Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

Kowalchik

Vallow

McDonough

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 99%

“…Previous publications have evaluated alterations in PBI recommendations after MRI (13)(14)(15)(16)(17)(18). These studies have examined tumor characteristics including multicentric, multifocal, and contralateral disease.…”

Section: Introductionmentioning

confidence: 99%

Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

Kowalchik

Vallow

McDonough

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

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“…Some authors analyzed the role of MRI in PBI setting and found that 5-10% of the patients initially considered for PBI resulted unsuitable because of MRI findings (18)(19)(20)(21). Houssami et al (22) analyzed 19 studies and observed that MRI can detect additional disease in the affected breast in the 16% of women with breast cancer, while 66% of these findings are confirmed as malignant at histology, during surgery or biopsy.…”

Section: Mri and Other Imaging Modalitiesmentioning

confidence: 99%

Patient selection for partial breast irradiation by intraoperative radiation therapy: can magnetic resonance imaging be useful?—perspective from radiation oncology point of view

Krengli

Pisani²,

Deantonio

2016

J. Thorac. Dis.

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The guidelines of the European and American Societies of Radiation Oncology (GEC-ESTRO and ASTRO) defined the selection criteria to offer partial breast irradiation (PBI) after lumpectomy in patients with low risk breast cancer regardless pre-operative staging. A recent publication by Tallet et al.explored the impact of preoperative magnetic resonance imaging (MRI) on patient eligibility for PBI. From their study, an ipsilateral BC was detected in 4% of patients, excluding these patients from intraoperative radiotherapy (IORT). The authors suggested that preoperative MRI should be used routinely for patient's candidate to IORT, because of the rate of ipsilateral breast cancer detected. In view of Tallet's article, we analyzed some aspects of this issue in order to envisage some possible perspective on how to better identify those patients who could benefit from PBI, especially using IORT. From historical studies, the risk of breast cancer recurrence outside index quadrant without irradiation is in the range of 1.5-3.5%. MRI sensitivity for detection of invasive cancer is reported up to 100%, and it is particularly useful in dense breast. Other imaging technique did not achieve the same sensibility and specificity as conventional MRI. Of note, none of randomized trials published and ongoing on PBI included preoperative MRI as part of staging. To perform a preoperative MRI in PBI setting is an interesting issue, but the available data suggest that this issue should be preferably studied in the setting of prospective clinical trials to clarify the role of MRI and the clinical meaning of the discovered additional foci.

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“…[46][47][48][49] The prospect of using MRI to tailor the approach to breast radiotherapy has been evaluated in the setting of partial breast irradiation. [53][54][55] These studies have been retrospective with various entry 54 performed a retrospective analysis of 450 patients, of whom 110 were eligible for partial irradiation. Additional disease (multifocal or multicentric) was found in 10%, with a false positive rate of 4.5%.…”

Section: Mri Role In Partial Breast Irradiationmentioning

confidence: 99%

“…55 Tendulkar et al most recently found additional disease in 5.8% and recommended MRI prior to consideration of partial breast irradiation. 53 The role of omission of adjuvant radiotherapy for low-risk patients 56 is an important consideration in the era of breast conserving treatment. Pre-operative MRI may aid in the selection of those who, in additional to favorable pathological features, may not require radiotherapy.…”

Section: Mri Role In Partial Breast Irradiationmentioning

confidence: 99%

The role of magnetic resonance imaging in early breast cancer

Skandarajah

Mann

2012

Asia-Pac J Clncl Oncology

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Despite recent evidence that fails to detect a benefit in surgical and local recurrence outcomes in those who receive optimal surgery and adjuvant systemic and radiotherapy, magnetic resonance imaging (MRI) is still being employed. We review the recent literature to clarify the role in the use of MRI in early breast cancer. A literature search using the Medline and Ovid databases was conducted between 2004 and 2011 using the terms "magnetic resonance imaging' and 'early breast cancer'. Only articles with clinical trials published in English in adult humans with available abstracts were included. Articles on high-risk women, response to neoadjuvant therapy, advanced breast cancer, the occult primary, the contralateral breast and technical articles were excluded. Articles examining the role of MRI in the staging of early breast cancer were retained. Over 260 articles regarding breast MRI have been published in the last 5 years. Additional foci may be found in 16% of patients but the impact on the extent of surgery and local recurrence rate is yet to be defined. Certain sub-groups who may benefit include those with invasive lobular carcinoma and mammographically dense breasts and those for consideration of partial breast irradiation. With standard adjuvant radiotherapy, there is no benefit in routine MRI with respect surgical extent and local recurrence. Should MRI be used, pre-operative biopsy to confirm additional disease must be undertaken prior to a change in surgical extent of resection. However, MRI may be useful in the evaluation of those who can be considered for partial breast irradiation. Centres undertaking breast MRI must have MRI-biopsy capabilities and constantly audit the reporting of MRI with correlation to the final pathology.

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Breast Magnetic Resonance Imaging in the Management of Early Breast Cancer: Implications for Partial Breast Irradiation

Cited by 11 publications

References 0 publications

Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

Patient selection for partial breast irradiation by intraoperative radiation therapy: can magnetic resonance imaging be useful?—perspective from radiation oncology point of view

The role of magnetic resonance imaging in early breast cancer

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