Comparison of intraductal spread on dynamic contrast-enhanced MRI with clinicopathologic features in breast cancer.
OBJECTIVE
Contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a new diagnostic technology in various breast cancer treatments. However, little is known about the correlation between intraductal spread on CE-MRI and clinicopathologic features. This study was designed to evaluate these correlations for the surgical planning of breast cancer.


METHODS
Twenty-six breast cancer lesions (in 26 female patients) treated by breast conserving surgery between March 2001 and March 2003 were evaluated retrospectively. CE-MRI was performed with a 1.5 T unit using a dedicated bilateral breast coil.


RESULTS
In detecting intraductal spread of breast cancer, the sensitivity, specificity and accuracy of CE-MRI were 82.4%, 60.0% and 77.3%, respectively. On mammography (MMG), these were 21.1%, 100.0% and 42.3%, respectively. Therefore, CE-MRI has a higher sensitivity and accuracy, although with a lower specificity than MMG. Compared with breast cancer lesions without intraductal spread on CE-MRI, lesions with intraductal spread on CE-MRI were found more frequently in larger-sized tumors (P = 0.0088).


CONCLUSIONS
Preoperative evaluation for intraductal spread by CE-MRI should be more useful than by MMG for breast cancer. When making the surgical decision regarding excision range, particular attention should be paid to this consideration for patients with larger-sized cancer tumors.
Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan. syuhei@mx.biwa.ne.jp
Shuhei
S
Komatsu
Chol Joo
CJ
Lee
Yohei
Y
Hosokawa
Daisuke
D
Ichikawa
Takashi
T
Hamashima
Koichi
K
Shirono
Harumi
H
Okabe
Hideaki
H
Kurioka
Takahiro
T
Oka
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media