[Diagnostic value of preoperative contrast-enhanced MR imaging of the breast].
OBJECTIVE
To evaluate preoperative contrast enhanced MR imaging in clinically, mammographically and/or ultrasonographically established breast cancer.


METHODS
From September 1998 to August 1999, preoperative contrast-enhanced MR imaging of the breast was performed in 91 patients with lesions highly suggestive of malignancy (BIRADS IV and V) by clinical, mammographic, and/or ultrasonographic criteria. MR imaging findings were postsurgically correlated with other imaging, intraoperative and histopathologic results.


RESULTS
Histopathologic analysis revealed 61 (66 %) malignant and 31 (34 %) benign lesions. In 63 (69 %) of the 91 investigated patients, MR mammographies were classified as tumor suspect and in the remaining 28 (31 %) cases as benign. The sensitivity, specificity and accuracy were 90 %, 67 % and 81 % for contrast-enhanced MR imaging. Additional tumor manifestations (multifocal or multicentric disease, contralateral carcinoma) were found by MR imaging alone in 10 patients (11 %).


CONCLUSIONS
Contrast-enhanced MR imaging may reveal unsuspected multifocal, multicentric or contralateral breast carcinoma that changes the surgical therapy if the intention is total tumor removal. The prognostic role of a potentially more radical surgical therapy on the basis of these findings is not clear.
Winnekendonk
G
G
Institut und Poliklinik für Radiologische Diagnostik der Universität zu Köln. guido.winnekendonk@medizin.uni-koeln.de
Krug
B
B
Warm
M
M
Göhring
U-J
UJ
Mallmann
P
P
Lackner
K
K
D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000175:diagnosis / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis / Q000473:pathology; D005348:Fibrocystic Breast Disease / Q000175:diagnosis / Q000473:pathology; D019786:Gadolinium DTPA; D006099:Granuloma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008413:Mastitis / Q000175:diagnosis / Q000473:pathology; D009367:Neoplasm Staging; D010173:Palpation; D011379:Prognosis; D012680:Sensitivity and Specificity; D013997:Time Factors; D016217:Ultrasonography, Mammary
D003287:Contrast Media; D019786:Gadolinium DTPA