Indicações de ressonância magnética das mamas em um centro de referência em oncologia

Abstract

Objective: To evaluate and discuss the indications for breast magnetic resonance imaging in an oncology reference center. Materials and Methods: Retrospective study approved by the Committee for Ethics in Research of the institution and developed through a review of patients' records and clinical reports. All the breast magnetic resonance studies performed in the period from July 2008 to July 2009 (n = 529) were included. Results: Mean patients' age was 49 years, ranging from 17 to 86 years. Family history of breast and/or ovarian cancer was present in 162 patients (30.6%). Most common indications for breast magnetic resonance imaging included inconclusive mammographic/sonographic findings (48.8%), evaluation of tumor recurrence/surgical scar after breast surgery (15.1%), disease staging/surgical planning (11.7%) and screening in high-risk patients (8.5%). Conclusion: In spite of inconclusive findings at conventional imaging studies being the most common indication for breast magnetic resonance imaging, there is no evidence in the literature supporting such a conduct. Because of its high sensitivity and high rate of false positive results, magnetic resonance imaging should be appropriately indicated in order to avoid unnecessary procedures. Once such method is appropriately indicated, it may contribute in the decision making process, constituting an essential tool in the assessment of breast lesions. Keywords: Magnetic resonance imaging; Breast neoplasms; Early detection of cancer.Objetivo: Avaliar e discutir as indicações de ressonância magnética das mamas em um centro de referência oncoló-gico. Materiais e Métodos: Estudo retrospectivo, aprovado pelo Comitê de Ética e Pesquisa da instituição, conduzido através da revisão de prontuários e laudos médicos. Foram incluídos todos os exames de ressonância magnética das mamas realizados no período de julho de 2008 a julho de 2009 (n = 529). Resultados: A idade média das pacientes foi de 49 anos, variando de 17 a 86 anos. História familiar de câncer de mama e/ou ovário esteve presente em 162 pacientes (30,6%). As indicações mais comuns de ressonância magnética das mamas foram esclarecimento de achados inconclusivos na mamografia e/ou ultrassom (48,8%), avaliação de recorrência tumoral/cicatriz cirúrgica (15,1%), estadiamento/planejamento cirúrgico (11,7%) e rastreamento de pacientes de alto risco (8,5%). Conclusão: Apesar de achados inconclusivos nos exames convencionais serem a indicação mais comum de ressonância magnética das mamas, não há evidências que justifiquem esta conduta na literatura. Em razão da sua alta sensibilidade e percentual de falso-positivos, este exame deve ser adequadamente indicado, para evitar a realização de procedimentos desnecessários. Se bem indicada, a ressonância magnética pode contribuir para o processo de tomada de decisão e constitui uma ferramenta fundamental na avaliação de lesões mamárias. Unitermos: Imagem por ressonância magnética; Neoplasias da mama; Detecção precoce de câncer. AbstractResumo

Breast cancer features in women under the age of 40 years

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Role of MRI in the staging of breast cancer patients: does histological type and molecular subtype matter?

“…One of the main indications for breast MRI is pre-operative staging, since this method has a high sensitivity in the evaluation of tumour extension and detection of multifocal and multicentric tumours. 1 MRI can identify additional tumour sites in 15-27% of patients in the same breast and 3-10% of patients in the contralateral breast. 2,3 MRI is especially useful not only in patients with diagnosis of invasive lobular carcinoma, owing to the increased risk of additional sites of disease, but also in females with cancer diagnosis where it is difficult to accurately delineate the extent of disease on standard modalities.…”

Performance of diagnostic centers in the classification of opportunistic screening mammograms from the Brazilian public health system (SUS)

“…The Brazilian radiological literature has recently been preoccupied with the relevant role of imaging methods in the improvement of breast diseases diagnosis (22)(23)(24)(25)(26)(27)(28)(29)(30)(31) . With the consolidation of data at SIS-MAMA, the evaluation of indicators based on national standards and proposed targets became possible by means of a contextualized observation of mammographic results reported by the SUS' diagnostic centers, allowing greater swiftness in the processing of data necessary for the planning and implementation of public health policies and better allocation of resources in this area (13) .…”