Breast carcinoma: MR imaging before re-excisional biopsy.
OBJECTIVE
To investigate the role of magnetic resonance (MR) imaging in the examination of patients after excisional biopsy of breast carcinoma before re-excision.


METHODS
Forty-seven patients underwent contrast material-enhanced MR imaging after initial excisional biopsy of breast carcinoma before further surgery.


RESULTS
The positive predictive value of MR imaging for predicting residual disease was 82%; the negative predictive value was 61%. Fourteen patients had multifocal (n = 6) or diffuse (n = 8) carcinoma. The extent of tumor was correctly identified with MR imaging alone in nine of the 14 patients, with both mammography and MR imaging in three patients, with mammography alone in one patient, and with no imaging modality in one patient. In four of the 14 patients, management was altered from re-excision to mastectomy (n = 3) or from breast-conservation therapy to mastectomy (n = 1).


CONCLUSIONS
MR imaging has a high positive predictive value for predicting residual tumor after excisional biopsy. The identification of mammographically and clinically unsuspected multifocal or extensive residual tumor may lend support for mastectomy rather than re-excision. However, false-negative findings due to postsurgical changes and false-positive findings due to enhancement of granulation tissue and benign breast tissue remain limitations.
Orel
S G
SG
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Reynolds
C
C
Schnall
M D
MD
Solin
L J
LJ
Fraker
D L
DL
Sullivan
D C
DC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D002277:Carcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D003287:Contrast Media; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D018365:Neoplasm, Residual; D011237:Predictive Value of Tests; D012086:Reoperation; D012680:Sensitivity and Specificity
D003287:Contrast Media