The prognostic value of additional malignant lesions detected by magnetic resonance imaging versus mammography

Saha, Sukamal; Freyvogel, Mary; Johnston, Gregory; Lawrence, Linda; Conlin, Chris; Hicks, Randy; Strahle, David; Korant, Alpesh; Shaik, Mohammed; Wiese, David

doi:10.1016/j.amjsurg.2014.05.004

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…The identification rate of MRI-only detected breast lesions before breast cancer surgery reportedly ranges from 18.8% to 31.2% overall, from 10.7% to 14.0% in the ipsilateral breast, and from 4.9% to 16.0% in the contralateral breast (Table 1) [1][2][3][4][5]. In addition, the frequency of cancer in MRI-only lesions tends to be higher in the ipsilateral breast (12.2%-85.7%) than in the contralateral breast (6.8%-25.0%).…”

Section: Prevalence Of Mri-only Detected Breast Lesions In Preoperati...mentioning

confidence: 99%

“…Breast magnetic resonance imaging (MRI) examination has high sensitivity and low specificity and is widely performed for preoperative evaluation of breast cancer spread, qualitative diagnosis of breast lesions already identified on other imaging modalities such as mammography (MG) or ultrasonography (US), and breast surveillance for patients with pathogenic variants in breast cancer susceptibility genes. MRI-only detected breast lesions that are not identified on MG or non-enhanced US (i.e., MRI+/MG-/US-) and have a possibility of being malignant may be observed preoperatively; however, the falsepositive rate of MRI-only lesions is reportedly high [1][2][3][4][5]. In particular, MRI-only lesions in other segments of the ipsilateral breast or contralateral breast may alter the surgical treatment of breast cancer, and indeed, preoperative MRI examination has been reported to increase the mastectomy rate [6].…”

Section: Introductionmentioning

confidence: 99%

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Third-look contrast-enhanced ultrasonography plus needle biopsy for differential diagnosis of magnetic resonance imaging-only detected breast lesions

Miyake

Shimazu

2023

J Med Ultrasonics

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Research has shown that in approximately 20% to 30% of cases, breast lesions that were not detected on mammography (MG) or ultrasonography (US) were incidentally found during preoperative magnetic resonance imaging (MRI) examination for breast cancer. MRI-guided needle biopsy is recommended or considered for such MRI-only detected breast lesions invisible on second-look US, but many facilities in Japan cannot perform this biopsy procedure because it is expensive and time-consuming. Thus, a simpler and more accessible diagnostic method is needed. Two studies to date have shown that third-look contrast-enhanced US (CEUS) plus needle biopsy for MRI-only detected breast lesions (i.e., MRI+/MG-/US-) that were not detected on second-look US showed moderate/high sensitivity (57.1% and 90.9%) and high specificity (100.0% in both studies) with no severe complications. In addition, the identification rate was higher for MRI-only lesions with a higher MRI BI-RADS category (i.e., category 4/5) than for those with a lower category (i.e., category 3). Despite the fact that there are limitations in our literature review, CEUS plus needle biopsy is a feasible and convenient diagnostic tool for MRI-only lesions invisible on second-look US and is expected to reduce the frequency of MRI-guided needle biopsy. When third-look CEUS does not reveal MRI-only lesions, a further indication for MRI-guided needle biopsy should be considered according to the BI-RADS category.

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Section: Prevalence Of Mri-only Detected Breast Lesions In Preoperati...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Third-look contrast-enhanced ultrasonography plus needle biopsy for differential diagnosis of magnetic resonance imaging-only detected breast lesions

Miyake

Shimazu

2023

J Med Ultrasonics

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“…It is worth noting too that although MRI has been mostly associated with an increase in total mastectomy rate, 9–11 MRI may also in selected cases downstage treatment to a partial rather than a total mastectomy 23 . Moreover, research has shown that additional malignant lesions detected by MRI only are associated with a 50% lymph node metastasis rate versus 20% in patients with a single malignant lesion, further pointing towards the fact that MRI detects clinically relevant disease 33,34 …”

Section: Discussionmentioning

confidence: 99%

“…23 Moreover, research has shown that additional malignant lesions detected by MRI only are associated with a 50% lymph node metastasis rate versus 20% in patients with a single malignant lesion, further pointing towards the fact that MRI detects clinically relevant disease. 33,34 While any change in surgical management based on MRI findings must be prompted by a positive biopsy result, even resecting additional biopsy-proven cancers has not yet shown any clear short-or long-term benefit. 24 However, as shown in our series and in the literature, the population of MRI-detected ACs is heterogeneous.…”

Section: Discussionmentioning

confidence: 99%

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Additional occult cancers identified on staging breast MRI: imaging appearances and pathologic characteristics

Nassar,

Nakad,

Abou Zeid

et al. 2023

J of Medical Radiation Sci

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IntroductionBreast magnetic resonance imaging (MRI) is increasingly being used for staging of patients with breast cancer due to its high sensitivity in detecting additional cancers (ACs). However, the clinical impact of diagnosing and treating these cancers remains unclear.MethodsA retrospective study was undertaken of patients with newly diagnosed breast cancer who underwent staging MRI at The American University of Beirut Medical Centre (AUBMC) between 2012 and 2020. Pathology reports and breast MRI examinations were reviewed. Eighteen breast cancer patients with 19 pathology‐proven index cancers (ICs) and 19 pathology‐proven MRI‐detected ACs were included. Chi‐square and Fisher's exact tests for categorical variables and Wilcoxon signed rank test for numerical variables were used to compare ICs to ACs.ResultsThe ICs consisted of four ductal carcinoma in situ (DCIS), 13 invasive ductal carcinomas (IDC), of which five with associated DCIS, and two invasive lobular carcinomas, (ILC) of which one with associated DCIS. ACs comprised 12 DCIS, five IDC, two with associated DCIS and two ILC, one with associated DCIS. Interval cancers were more frequently invasive whereas ACs were more frequently in situ (P = 0.021). ACs were more frequently nuclear grade 2 (P = 0.009). There was no statistically significant difference between ICs and ACs in lesion type (P = 0.062), shape (P = 0.073), initial enhancement (P = 1), delayed enhancement (P = 0.732), hormonal receptor profile (P = 0.68) and Ki67 (P = 0.388). Among ACs, ten (53%) were larger than 10 mm of which five (26%) were invasive cancers, and five (26%) were larger than the ICs.ConclusionsACs detected by breast MRI were more likely to be in situ and to show a nuclear grade 2. Although not reaching statistical significance, some ACs tend to be clinically significant by their type, size or nuclear grade. The impact on clinical management remains to be determined.

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The Japanese breast cancer society clinical practice guidelines for breast cancer screening and diagnosis, 2022 edition

Kubota,

Nakashima,

Nakashima

et al. 2023

Breast Cancer

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This article provides updates to readers based on the newly published Japanese Breast Cancer Society Clinical Practice Guidelines for Breast Cancer Screening and Diagnosis, 2022 Edition. These guidelines incorporate the latest evaluation of evidence from studies of diagnostic accuracy. For each clinical question, outcomes for benefits and harms were established, and qualitative or quantitative systematic reviews were conducted. Recommendations were determined through voting by a multidisciplinary group, and guidelines were documented to facilitate shared decision-making among patients and medical professionals. The guidelines address screening, surveillance, and pre- and postoperative diagnosis of breast cancer. In an environment that demands an integrated approach, decisions are needed on how to utilize modalities, such as mammography, ultrasound, MRI, and PET/CT. Additionally, it is vital to understand the appropriate use of new technologies, such as tomosynthesis, elastography, and contrast-enhanced ultrasound, and to consider how best to adapt these methods for individual patients.

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The prognostic value of additional malignant lesions detected by magnetic resonance imaging versus mammography

Cited by 4 publications

References 10 publications

Third-look contrast-enhanced ultrasonography plus needle biopsy for differential diagnosis of magnetic resonance imaging-only detected breast lesions

Third-look contrast-enhanced ultrasonography plus needle biopsy for differential diagnosis of magnetic resonance imaging-only detected breast lesions

Additional occult cancers identified on staging breast MRI: imaging appearances and pathologic characteristics

The Japanese breast cancer society clinical practice guidelines for breast cancer screening and diagnosis, 2022 edition

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