False-negative MR imaging of malignant breast tumors

Boetes, C.; Strijk, S. P.; Holland, Roland; Barentsz, Jelle O.; Sluis, R.F. van der; Ruijs, J. H. J.

doi:10.1007/s003300050281

Cited by 145 publications

(78 citation statements)

References 14 publications

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“…Orel et al (31) stated that the sensitivity of MRI was 77% in DCIS diagnosis, and Fischer et al (12) indicated that the histopathological diagnosis was DCIS in 29 of 30 false negative lesions. Furthermore, Boetes et al (32) reported that among 204 cases, analysis of the malignant tumors that were not detected in the MRI revealed that the false negative rate for the existence of DCIS was 23%; the majority of these occult lesions were DCIS. The sensitivity of MRI in DCIS diagnosis is reported to vary between 40% and 100% (3,31,32).…”

Section: B C Amentioning

confidence: 99%

“…Furthermore, Boetes et al (32) reported that among 204 cases, analysis of the malignant tumors that were not detected in the MRI revealed that the false negative rate for the existence of DCIS was 23%; the majority of these occult lesions were DCIS. The sensitivity of MRI in DCIS diagnosis is reported to vary between 40% and 100% (3,31,32). The reasons that have been noted for false negativity include the lesion size, the variable histological characteristics of DCIS, and the degree of tumor angiogenesis (31).…”

Section: B C Amentioning

confidence: 99%

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The role of breast magnetic resonance imaging on surgical treatment planning of breast cancer

Duygulu¹,

Oktay²,

Bilgen³

et al. 2012

Diagn Interv Radiol

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460C ontrast-enhanced magnetic resonance imaging (MRI) is a complementary imaging technique that is increasingly used in the surgical treatment planning of breast cancer. Contrast-enhanced MRI has a sensitivity of 40%-100% in detecting ductal carcinoma in situ (DCIS) and up to 100% sensitivity in detecting invasive breast cancer (1, 2). In many studies, MRI had a higher accuracy than mammography (MMG) and ultrasonography (US) in detecting multiple malignant foci, in defining the actual size and spread of a solitary tumor, and in diagnosing contralateral synchronous breast cancer (3-5).Many studies have indicated various detection rates of MRI (16%-37%) for occult multiple lesions. The detection rate for a larger spread of the cancer is as high as 34% (1,5,6).Larger extension of local disease affects not only the surgical and systemic treatment but also the axillary lymph node approach for staging leading to a direct full axillary dissection instead of sentinel node excision (5, 7).Our objective in this prospective study was to investigate 1) the rate at which additional evidence is obtained with a pre-operative MRI and 2) how often the MRI findings change the surgical plan in patients for whom physical examination, MMG, and US findings make them candidates for breast-conserving surgery. Materials and methodsThe study was approved by the Ethics Committee of the Ege University School of Medicine. Retrospective analyses were performed on the prospectively obtained information. All of the patients were asked to read and sign informed consent prior to the MRI examination.Contrast-enhanced breast MRIs were performed on 69 female patients undergoing physical examination, MMG, and US between August 2006 and December 2008. These patients exhibited evidence of breast cancer based on clinical and radiologic findings and were candidates for breastconserving surgery.Inclusion criteria were as follows: 1) Cytologically or histopathologically (fine-needle aspiration biopsy, Tru-cut excisional or incisional biopsy) proven breast cancer, 2) In accordance with the TNM classification used for malignant tu- All of the enrolled patients were believed to be candidates for breast conservation on the basis of physical examination, mammography, and ultrasonography. The patients were reevaluated with the MRI examination as to whether they were still candidates for breast conservation therapy. RESULTSThe MRI findings changed the previous management plans in 19.1% of the 68 patients. With respect to the surgical approach, no statistically significant difference was observed between the histopathology groups (P = 0.403). In terms of the breast parenchymal pattern, however, surgical planning was changed in 53.8% of the patients who exhibited a dense pattern, which was significantly different from the rates of the other groups (P = 0.006). The sensitivity, specificity, positive predictive value, and negative predictive value of the MRI for additional malignant lesion detection and identification were 85%, 98%, 92%, and 96%, respectively. The...

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Section: B C Amentioning

confidence: 99%

Section: B C Amentioning

confidence: 99%

The role of breast magnetic resonance imaging on surgical treatment planning of breast cancer

Duygulu¹,

Oktay²,

Bilgen³

et al. 2012

Diagn Interv Radiol

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“…Balu-Maestro et al (6) found that ultrasound and mammography detected a smaller fraction of the cases of multifocal tumors than MRi. one caveat when using MRi to detect and monitor breast tumors is that, even though the method has a high sensitivity (95%-97%), it has a poor specificity (30%-97% depending on the series) (12,28), making it necessary that a suspect lesion be proven by guided biopsies.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Noninvasive Imaging of Breast Cancer

Medarova

2009

Biotechnology & Biotechnological Equipment

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“…The pathophysiology of DCIS may explain its features on MRI. 23,24 Unlike a mammography, which detects calcification due to necrosis in DCIS, MRI identifies altered perfusion due to angiogenesis and neovascularization. DCIS features on MRI are often subtle, compared with those of invasive cancer, with a common finding of asymmetric enhancement patterns.…”

Section: Detection Of Additional Diseasementioning

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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False-negative MR imaging of malignant breast tumors

Cited by 145 publications

References 14 publications

The role of breast magnetic resonance imaging on surgical treatment planning of breast cancer

The role of breast magnetic resonance imaging on surgical treatment planning of breast cancer

Noninvasive Imaging of Breast Cancer

The role of magnetic resonance imaging in early breast cancer

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