Characterization of Metastatic Sternal Lesions on Dynamic Contrast-Enhanced Breast MRI in Women with Invasive Breast Cancer

Lee, Amie Y.; Navarro, Ryan; Busby, Lindsay P; Greenwood, Heather; Bucknor, Matthew; Ray, Kimberly M.; Joe, Bonnie N.

doi:10.1016/j.acra.2018.11.011

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…Schaefer et al noted that the 8 cases designated as benign in their series had only 1-2 lesions of which the largest was 11 mm in diameter. 4 Lee et al reported that all 12 of the metastatic lesions in their study were >10 mm while 9/10 of the benign lesions (all from routine screening MRI studies) were <10 mm. 5 A washout kinetic pattern is frequent with sternal metastases but can also occur in benign lesions including haemangiomas (Fig.…”

Section: Introductionmentioning

confidence: 88%

“…Multiple lesions or size >10 mm would be exceptions to this rule. Schaefer et al noted that the 8 cases designated as benign in their series had only 1–2 lesions of which the largest was 11 mm in diameter 4 . Lee et al.…”

Section: Introductionmentioning

confidence: 97%

“…3 In a more recent study, patients with metastatic lesions detected on either PET/CT or bone scan had their prior breast MRI scans reviewed. Of 14 sternal metastases, Lee et al 4 found that 12 (86%) were retrospectively identifiable on breast MRI, but only 8 (57%) had been prospectively reported. Clearly then, the sternum should be carefully reviewed in all breast MRI studies performed in the context of a breast cancer diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…2). 3,4 In the setting of either current or previous breast cancer, any enhancing sternal lesion should always be carefully evaluated and should prompt a PET/CT scan (Figs 2 and 3). Metastases will usually but not invariably exhibit low marrow signal on T1 and T2 spin-echo images due to replacement by tumour (Figs 4 and 5).…”

Section: Introductionmentioning

confidence: 99%

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The sternum: An important review area when reporting pre‐surgical staging breast MRI studies

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2021

J Med Imag Rad Onc

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Identification and assessment of extramammary findings on contrast-enhanced breast MRI scans is particularly important in the setting of newly diagnosed invasive cancer as metastatic lesions may be encountered in the liver, lungs, pleural cavity or bones. Establishing that stage IV disease is present has a profound effect on patient management. The sternum is routinely included on breast MRI studies and can be an early site for breast cancer metastases. These appear as enhancing lesions with high signal on fat-suppressed T2-weighted images. However, incidental benign lesions, notably haemangiomas, may also be encountered, and careful analysis is required to avoid false-positive results. Clinical context is important with a much lower likelihood of malignancy in the setting of routine screening of young women with no personal history of breast cancer. This pictorial essay illustrates findings encountered with lesions in the sternum and offers insights into how to interpret and manage them.

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Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The sternum: An important review area when reporting pre‐surgical staging breast MRI studies

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2021

J Med Imag Rad Onc

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Percutaneous image-guided sternal biopsy: a cross-institutional retrospective review of diagnostic yield and safety in 50 cases

Wingfield

Mills

et al. 2020

Skeletal Radiol

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Bone Lesions Detected on Breast MRI: Clinical Outcomes and Features Associated With Metastatic Breast Cancer

Corines

Coffey

Dou

et al. 2022

Journal of Breast Imaging

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Objective To determine prevalence and frequency of malignancy among bone lesions detected on breast MRI and to identify clinical and imaging features associated with bone metastases from breast cancer (BC), as bone lesions are suboptimally evaluated on breast imaging protocols and can present a diagnostic challenge. Methods This IRB-approved retrospective review of breast MRIs performed from June 2009 to June 2018 identified patients with bone lesions. Demographic, clinical, and MRI features were reviewed. Clinical outcome of bone lesions was determined based on pathology and/or additional diagnostic imaging. All benign lesions had ≥2 years of imaging follow-up. Statistics were computed using Fisher exact and Wilcoxon rank sum tests. Results Among all patients with breast MRI, 1.2% (340/29 461) had bone lesions. Of these, 224 were confirmed benign or metastatic BC by pathology or imaging follow-up, with 70.1% (157/224) benign and 29.9% (67/224) metastatic. Bone metastases were associated with BC history (P < 0.001), with metastases occurring in 58.2% (53/91) of patients with current BC, 17.9% (14/78) patients with prior BC, and 0.0% (0/55) without BC. Bone metastases were associated with invasive and advanced stage BC and, on MRI, with location in sternum, ribs, or clavicles, larger size, multiplicity, and T1 hypointensity (all P < 0.01 in tests of overall association). Conclusion Of clinically confirmed breast MRI–detected bone lesions, 30% were bone metastases; all were detected in patients with current or prior BC. Metastases were associated with advanced stage, invasive carcinoma, larger lesion size, multiplicity, low T1 signal, and non-spine location.

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Characterization of Metastatic Sternal Lesions on Dynamic Contrast-Enhanced Breast MRI in Women with Invasive Breast Cancer

Cited by 5 publications

References 24 publications

The sternum: An important review area when reporting pre‐surgical staging breast MRI studies

The sternum: An important review area when reporting pre‐surgical staging breast MRI studies

Percutaneous image-guided sternal biopsy: a cross-institutional retrospective review of diagnostic yield and safety in 50 cases

Bone Lesions Detected on Breast MRI: Clinical Outcomes and Features Associated With Metastatic Breast Cancer

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