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Background parenchymal enhancement in preoperative breast MRI.

Kohara S, Ishigaki S, Satake H, Kawamura A, Kawai H, Kikumori T, Naganawa S - Nagoya J Med Sci (2015)

Bottom Line: The correlations between the BPE grade and age, menopausal status, index tumor size, changes in surgical management based on MRI results, positive predictive value (PPV) of MRI, and surgical margins were assessed.Patients in the strong BPE groups were significantly younger (p=0.002) and generally premenopausal (p<0.001).Strong BPE causes false-positive MRI findings and may lead to overly extensive surgery, whereas MRI may be beneficial in select patients with weak BPE.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

ABSTRACT
We aimed to assess the influence of background parenchymal enhancement (BPE) on surgical planning performed using preoperative MRI for breast cancer evaluation. Between January 2009 and December 2010, 91 newly diagnosed breast cancer patients (mean age, 55.5 years; range, 30-88 years) who underwent preoperative bilateral breast MRI followed by planned breast conservation therapy were retrospectively enrolled. MRI was performed to assess the tumor extent in addition to mammography and breast ultrasonography. BPE in the contralateral normal breast MRI at the early dynamic phase was visually classified as follows: minimal (n=49), mild (n=27), moderate (n=7), and marked (n=8). The correlations between the BPE grade and age, menopausal status, index tumor size, changes in surgical management based on MRI results, positive predictive value (PPV) of MRI, and surgical margins were assessed. Patients in the strong BPE groups were significantly younger (p=0.002) and generally premenopausal (p<0.001). Surgical treatment was not changed in 67 cases (73.6%), while extended excision and mastectomy were performed in 12 cases (13.2%), each based on additional lesions on MRI. Six of 79 (7.6%) patients who underwent breast conservation therapy had tumor-positive resection margins. In cases where surgical management was changed, the PPV for MRI-detected foci was high in the minimal (91.7%) and mild groups (66.7%), and 0% in the moderate and marked groups (p=0.002). Strong BPE causes false-positive MRI findings and may lead to overly extensive surgery, whereas MRI may be beneficial in select patients with weak BPE.

No MeSH data available.


Related in: MedlinePlus

A 35-year-old premenopausal woman with invasive ductal carcinoma of the left breast who underwent preoperative breast MRI. The tumor is not shown on the image. The post-contrast, fat-suppressed T1-weighted image of the first phase of dynamic study shows mild background enhancement.
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fig2: A 35-year-old premenopausal woman with invasive ductal carcinoma of the left breast who underwent preoperative breast MRI. The tumor is not shown on the image. The post-contrast, fat-suppressed T1-weighted image of the first phase of dynamic study shows mild background enhancement.


Background parenchymal enhancement in preoperative breast MRI.

Kohara S, Ishigaki S, Satake H, Kawamura A, Kawai H, Kikumori T, Naganawa S - Nagoya J Med Sci (2015)

A 35-year-old premenopausal woman with invasive ductal carcinoma of the left breast who underwent preoperative breast MRI. The tumor is not shown on the image. The post-contrast, fat-suppressed T1-weighted image of the first phase of dynamic study shows mild background enhancement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4574324&req=5

fig2: A 35-year-old premenopausal woman with invasive ductal carcinoma of the left breast who underwent preoperative breast MRI. The tumor is not shown on the image. The post-contrast, fat-suppressed T1-weighted image of the first phase of dynamic study shows mild background enhancement.
Bottom Line: The correlations between the BPE grade and age, menopausal status, index tumor size, changes in surgical management based on MRI results, positive predictive value (PPV) of MRI, and surgical margins were assessed.Patients in the strong BPE groups were significantly younger (p=0.002) and generally premenopausal (p<0.001).Strong BPE causes false-positive MRI findings and may lead to overly extensive surgery, whereas MRI may be beneficial in select patients with weak BPE.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

ABSTRACT
We aimed to assess the influence of background parenchymal enhancement (BPE) on surgical planning performed using preoperative MRI for breast cancer evaluation. Between January 2009 and December 2010, 91 newly diagnosed breast cancer patients (mean age, 55.5 years; range, 30-88 years) who underwent preoperative bilateral breast MRI followed by planned breast conservation therapy were retrospectively enrolled. MRI was performed to assess the tumor extent in addition to mammography and breast ultrasonography. BPE in the contralateral normal breast MRI at the early dynamic phase was visually classified as follows: minimal (n=49), mild (n=27), moderate (n=7), and marked (n=8). The correlations between the BPE grade and age, menopausal status, index tumor size, changes in surgical management based on MRI results, positive predictive value (PPV) of MRI, and surgical margins were assessed. Patients in the strong BPE groups were significantly younger (p=0.002) and generally premenopausal (p<0.001). Surgical treatment was not changed in 67 cases (73.6%), while extended excision and mastectomy were performed in 12 cases (13.2%), each based on additional lesions on MRI. Six of 79 (7.6%) patients who underwent breast conservation therapy had tumor-positive resection margins. In cases where surgical management was changed, the PPV for MRI-detected foci was high in the minimal (91.7%) and mild groups (66.7%), and 0% in the moderate and marked groups (p=0.002). Strong BPE causes false-positive MRI findings and may lead to overly extensive surgery, whereas MRI may be beneficial in select patients with weak BPE.

No MeSH data available.


Related in: MedlinePlus