Breast MRI in clinically and mammographically occult breast cancer presenting with an axillary metastasis: A systematic review

Bresser, Jeroen de; Vos, B. de; Ent, F. van der; Hulsewé, Karel W. E.

doi:10.1016/j.ejso.2009.09.007

Cited by 117 publications

(59 citation statements)

References 26 publications

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“…Magnetic resonance imaging (MRI) has proven its promise in the detection of asymptomatic or occult breast lesions with high sensitivity [3,4,5]. MRI also provides valuable information for detecting multicentric breast cancer in women with dense breasts [6].…”

Section: Introductionmentioning

confidence: 99%

Breast Cancers Detected by Breast MRI Screening and Ultrasound in Asymptomatic Asian Women: 8 Years of Experience in Taiwan

Cheng

et al. 2012

Oncology

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Background: This study investigated one-stop breast screening combining magnetic resonance imaging (MRI) and ultrasound (US) in asymptomatic Asian women. Methods: 3,586 asymptomatic women (mean age, 45.3 years) were retrospectively analyzed by breast MRI followed by US. US-guided biopsy was performed when the MRI-detected lesion was confirmed by US. When the lesion was not detected on the initial US, a second-look US guided by MRI findings was performed. Then biopsy was done. MRI-positive and US-negative patients were followed up according to MRI lesion size, MRI lesion morphology, and mammographic diagnosis. Results: In total, 115 subjects had suspicious malignant lesions and received US-guided biopsy, and 47 malignant lesions, including 35 invasive cancers and 12 carcinoma in situ (CIS) lesions, were diagnosed. More than half (22/35, 63%) of the women with invasive cancer were <50 years of age, and 27 (57.4%) of the 47 cancer cases had early breast cancers. Two invasive cancers (5.7%) and 7 CIS lesions (58.3%) were found at the second-look US. The overall cancer incidence was 1.31% (47/3,586) and increased to 2.2% (78/3,586) if precancerous lesions were included. Subjects aged 41-50 years had the highest incidence of cancer detection (1.97%). Five MRI and US-negative cases had cancers found 1 year after the screening. Conclusions: The results from the one-stop breast screening in this study showed that combining MRI and US is an efficient multimodality tool for screening asymptomatic Asian women in a metropolitan area of Taiwan who had concerns about the diagnosis and radiation of mammography.

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Section: Introductionmentioning

confidence: 99%

Breast Cancers Detected by Breast MRI Screening and Ultrasound in Asymptomatic Asian Women: 8 Years of Experience in Taiwan

Cheng

et al. 2012

Oncology

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“…Ipsilateral axillary lymphadenopathy is the fi rst clinical symptom in 0.3-1.0 % of all breast carcinomas [ 60 ]. Buchanan et al investigated female patients with unilateral axillary lymphadenopathy without clinical or mammographic detection of a primary tumor in the breast and reported that contrast-enhanced MRI detected >50 % of these primarily occult breast carcinomas [ 47 ].…”

Section: Breast Cancermentioning

confidence: 98%

The Radiologist’s Approach to CUP

Kazmierczak

Rominger

Cyran

2016

Cancer of Unknown Primary

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In 2-4 % of patients with histologically proven cancer, the primary tumor cannot be localized, even by use of modern diagnostic methods. This situation is clinically described as cancer of unknown primary (CUP) [ 1 , 2 ] and has a frequency similar to pancreatic cancer, renal cell carcinoma, or leukemia [ 3 ]. Even after extensive diagnostic workup using state-of-the-art methods, less than 20 % of primary tumors are localized antemortem, compared to almost 80 % of primary tumors identifi ed in postmortem autopsy series [ 4 ].CUP tumors are adenocarcinomas in 40-60 %, undifferentiated carcinomas in 15-20 %, squamous cell carcinomas in 5-8 %, and neuroendocrine tumors in 3-5 %; 1-3 % of all CUP belong to other entities [ 5 ]. Most frequently, primary tumors are localized in the lung (20-35 %) and the pancreas (15-20 %), followed by other gastrointestinal and gynecological malignancies. Median survival in this heterogenic group of cancer patients is only 3-11 months [ 6 ]. Imaging is essential in all four steps of the diagnostic and therapeutic management of CUP patients [ 7 ]: localization of the primary tumor, identifi cation of all manifestations, identifi cation of potentially treatable tumors (i.e., breast cancer, prostate carcinoma, lymphoma, etc.), and characterization of the clinicopathological entity and stratifi cation into subsets with favorable prognosis (approximately 20 %) with differentiated and/or chemosensitive tumors for which specifi c treatment options are available and, on

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“…However, clinical examination, mammography, and US are not able to identify the cancer. MRI sensitivity for detecting unknown breast cancer ranges from 25% to 86% [14]. When MRI is positive, adequate surgical treatment consists of lumpectomy or mastecomy according to lesion size and location.…”

Section: Occult Primary Cancermentioning

confidence: 99%

MRI of the Breast: Current Indications and Outlook to the Future

Kinkel

2014

Diseases of the Abdomen and Pelvis 2014–2017

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Breast MRI in clinically and mammographically occult breast cancer presenting with an axillary metastasis: A systematic review

Cited by 117 publications

References 26 publications

Breast Cancers Detected by Breast MRI Screening and Ultrasound in Asymptomatic Asian Women: 8 Years of Experience in Taiwan

Breast Cancers Detected by Breast MRI Screening and Ultrasound in Asymptomatic Asian Women: 8 Years of Experience in Taiwan

The Radiologist’s Approach to CUP

MRI of the Breast: Current Indications and Outlook to the Future

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