Predictive value of breast magnetic resonance imaging in detecting mammographically occult contralateral breast cancer: Can we target women more likely to have contralateral breast cancer?

Susnik, Barbara; Schneider, Lisa; Swenson, Karen K.; Krueger, Janet; Braatz, Christina; Lillemoe, Tamera J.; Tsai, Michaela L.; DeFor, Todd E.; Knaack, Monica; Rueth, Natasha M.

doi:10.1002/jso.25130

Cited by 9 publications

(4 citation statements)

References 29 publications

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“…We also observe a numerical but not statistically signi cant increase of bilateral mastectomy cases in patients received pre-operative evaluation with MRI than conventional imaging only group ( (50% versus 16.6%), the detected synchronous contralateral breast cancer were associated with higher in situ carcinoma. These ndings could explain why synchronous contralateral breast cancer, which usually presented in an earlier stage than the primary breast cancer [13], was a challenge for clinicians for early detection.…”

Section: Discussionmentioning

confidence: 98%

Impact of Pre-Operative Breast Magnetic Resonance Imaging (MRI) on Contralateral Synchronous and Metachronous Breast Cancer Detection- A Case Control Comparison Study With Mean Follow-Up of 102 Months.

Wu¹,

Chen²,

Lee³

et al. 2021

Preprint

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Background: Women with unilateral breast cancer are at an increased risk for the development of contralateral breast cancers. We hypothesis that combined breast MRI would detect more contralateral synchronous breast cancer than conventional imaging alone, and resulted in less contralateral metachronous breast cancer during follow-up. Methods: In this case control analysis, we retrospectively collected two groups of patients for evaluating the effectiveness and value of adding pre-operative breast MRI to conventional breast images (mammography and sonography) for detection of contralateral synchronous breast cancer. The new metachronous contralateral breast cancer diagnosed during follow-up was prospectively evaluated and compared. Results: Group A (n=733) comprised patients who underwent conventional preoperative imaging and group B (n=735) combined with MRI were enrolled and compared. Seventy (9.5%) of the group B patients were found to have contralateral lesions detected by breast MRI, and 65.7% of these lesions only visible with MRI. The positive predictive value of breast MRI detected contralateral lesions was 48.8%. With the addition of breast MRI to conventional imaging studies, more surgical excisions were performed in contralateral breasts (6% (44/735) versus 1.4% (10/733), P< 0.01), more synchronous contralateral breast cancer detected (2.9% (21/735) versus 1.1% (8/733), P=0.02), and resulted in numerical less (2.2% (16/714) versus 3% (22/725), p=0.3) metachronous contralateral breast cancer during a mean follow-up of 102 months. Conclusions: Combining pre-operative breast MRI evaluation resulted in an increase of contralateral synchronous breast cancer detection, and a numerical less subsequent contralateral metachronous breast cancer occurrence compared to conventional imaging alone.

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Section: Discussionmentioning

confidence: 98%

Impact of Pre-Operative Breast Magnetic Resonance Imaging (MRI) on Contralateral Synchronous and Metachronous Breast Cancer Detection- A Case Control Comparison Study With Mean Follow-Up of 102 Months.

Wu¹,

Chen²,

Lee³

et al. 2021

Preprint

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show abstract

“…Compared with the pathology of the primary index breast cancer, either in the combined MRI group (61.9% versus 15.9%, P<0.01) or in the conventional breast imaging cohort (50% versus 16.6%), the detected synchronous contralateral breast cancers were associated with higher in situ carcinoma. These findings could explain why synchronous contralateral breast cancer, which usually presented in an earlier stage than the primary breast cancer [ 13 ], was a challenge for clinicians for early detection.…”

Section: Discussionmentioning

confidence: 99%

“…Contrast-enhanced dynamic magnetic resonance imaging (MRI) has been shown to be a useful imaging modality for the diagnosis of breast cancer [8,9], estimating tumor size [10,11], and detecting occult breast lesions [2,3,12]. Some studies reported that breast MRI can detect 3-5% of occult tumors in the contralateral breast [1][2][3][4][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. However, case control comparison study for evaluation of adding breast MRI to conventional breast imaging for contralateral synchronous breast cancer detection, and the impact of pre-operative MRI to the subsequent occurrence of metachronous contralateral breast cancer was rarely reported [21,24].…”

Section: Introductionmentioning

confidence: 99%

Impact of pre-operative breast magnetic resonance imaging on contralateral synchronous and metachronous breast cancer detection—A case control comparison study with 1468 primary operable breast cancer patients with mean follow-up of 102 months

Chen²,

Lee

et al. 2021

PLoS ONE

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Background Women with unilateral breast cancer are at an increased risk for the development of contralateral breast cancers. We hypothesis that combined breast MRI would detect more contralateral synchronous breast cancer than conventional imaging alone, and resulted in less contralateral metachronous breast cancer during follow-up. Methods We retrospectively collected two groups of breast cancer patients diagnosed from 2009 to 2013 for evaluating the effectiveness and value of adding pre-operative breast MRI to conventional breast images (mammography and sonography) for detection of contralateral synchronous breast cancer. The new metachronous contralateral breast cancer diagnosed during follow-up was prospectively evaluated and compared. Results Group A (n = 733) comprised patients who underwent conventional preoperative imaging and group B (n = 735) combined with MRI were enrolled and compared. Seventy (9.5%) of the group B patients were found to have contralateral lesions detected by breast MRI, and 65.7% of these lesions only visible with MRI. The positive predictive value of breast MRI detected contralateral lesions was 48.8%. With the addition of breast MRI to conventional imaging studies, more surgical excisions were performed in contralateral breasts (6% (44/735) versus 1.4% (10/733), P< 0.01), more synchronous contralateral breast cancer detected (2.9% (21/735) versus 1.1% (8/733), P = 0.02), and resulted in numerical less (2.2% (16/714) versus 3% (22/725), p = 0.3) metachronous contralateral breast cancer during a mean follow-up of 102 months. Conclusions Our study provides useful estimates of the pre-operative breast MRI for the increased detection of contralateral synchronous breast cancer and less subsequent contralateral metachronous breast cancer.

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“…Breast magnetic resonance imaging (MRI) is an indispensable modality in the detection of breast tumors (1). Current applications of breast MRI include the staging of known cancers (2)(3)(4)(5), contralateral breast examination (6)(7)(8), breast cancer screening for women at high risk (9,10), treatment evaluation after neoadjuvant chemotherapy (11), and the evaluation of carcinomas of unknown primary origin (12,13). In 2003, the first edition of the American College of Radiology (ACR) breast imaging reporting and data system (BI-RADS) was published, which provided a structured common language for and standardized the reporting of breast MRI (14).…”

Section: Introductionmentioning

confidence: 99%

A simplified scoring protocol to improve diagnostic accuracy with the breast imaging reporting and data system in breast magnetic resonance imaging

Zhong¹,

Li²,

Zhu³

et al. 2022

Quant Imaging Med Surg

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Background:The breast imaging reporting and data system (BI-RADS) lexicon provides a standardized terminology for describing leision characteristics but does not provide defined rules for converting specific imaging features into diagnostic categories. The inter-reader agreement of the BI-RADS is moderate. In this study, we explored the use of a simplified protocol and scoring system for BI-RADS categorization which integrates the morphologic features (MF), kinetic time-intensity curve (TIC), and apparent diffusion coefficient (ADC) values with equal weights, with a view to providing a convenient and practical method for breast magnetic resonance imaging (MRI) and improving the inter-reader agreement and diagnostic performance of BI-RADS.Methods: This cross-sectional, retrospective, single-center study included 879 patients with 898 histopathologically verified lesions who underwent an MRI scan on a 3.0 Tesla GE Discovery 750 MRI scanner between January 1, 2017, and June 30, 2020. The BI-RADS categorization of the studied lesions was assessed according to the sum of the assigned scores (the presence of malignant MF, lower ADC, and suspicious TIC each warranted a score of +1). Total scores of +2 and +3 were classified as category 5, scores of +1 were classified as category 4, and scores of +0 but with other lesions of interest were classified as category 3. The receiver operating characteristic (ROC) curves were plotted, and the sensitivity, specificity, and accuracy of this categorization were investigated to assess its efficacy and its consistency with pathology.Results: There were 472 malignant, 104 risk, and 322 benign lesions. Our simplified scoring protocol had high diagnostic accuracy, with an area under curve (AUC) value of 0.896. In terms of the borderline effect of pathological risk and category 4 lesions, our results showed that when risk lesions were classified together with malignant ones, the AUC value improved (0.876 vs. 0.844 and 0.909 vs. 0.900). When category 4 and 5 lesions were classified as malignant, the specificity, accuracy, and AUC value decreased (82.3% vs. 93.2%, 89.3% vs. 90.2%, and 0.876 vs. 0.909, respectively). Therefore, to improve the diagnostic accuracy of the protocol for BI-RADS categorization, only category 5 lesions should be considered to be malignant. Conclusions:Our simplified scoring protocol that integrates MF, TIC, and ADC values with equal

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Predictive value of breast magnetic resonance imaging in detecting mammographically occult contralateral breast cancer: Can we target women more likely to have contralateral breast cancer?

Abstract: Preoperative MRI is most effective in detecting early stage, hormone receptor-positive CBC in older women.

Cited by 9 publications

References 29 publications

Impact of Pre-Operative Breast Magnetic Resonance Imaging (MRI) on Contralateral Synchronous and Metachronous Breast Cancer Detection- A Case Control Comparison Study With Mean Follow-Up of 102 Months.

Impact of Pre-Operative Breast Magnetic Resonance Imaging (MRI) on Contralateral Synchronous and Metachronous Breast Cancer Detection- A Case Control Comparison Study With Mean Follow-Up of 102 Months.

Impact of pre-operative breast magnetic resonance imaging on contralateral synchronous and metachronous breast cancer detection—A case control comparison study with 1468 primary operable breast cancer patients with mean follow-up of 102 months

A simplified scoring protocol to improve diagnostic accuracy with the breast imaging reporting and data system in breast magnetic resonance imaging

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