title: The efficacy of breast MRI in predicting breast conservation therapy.
abstract: BACKGROUND
  Breast conservation therapy (BCT) has equal efficacy compared to mastectomy in treating breast cancer. Accurate pre-operative measurement of tumor size can limit re-excision procedures. Breast MRI may improve pre-operative evaluation of extent of disease.
  
  
  OBJECTIVE
  To examine the correlation of extent of disease on breast MRI with pathologic data to determine the utility of breast MRI in surgical planning of BCT.
  
  
  METHODS
  We retrospectively reviewed our prospective database of women undergoing breast MRI. We identified 115 women with breast cancer who underwent a breast MRI and a surgical resection from 2000 to 2003. We compared patients with high-grade tumors (HG, n = 40) to patients with low grade (LG, n = 75).
  
  
  RESULTS
  The size of the tumor on MRI correlated with the pathologic size for HG tumors (HG R = 0.76 vs. LG R = 0.45, P = 0.033). Mastectomy was performed in 53 patients. In 10 patients with LG tumors, the MRI findings overestimated their disease. In 11 out of 115 patients the primary tumor or a second tumor was only seen by MRI.
  
  
  CONCLUSIONS
  Breast MRI does change surgical management by detecting additional malignancies. Breast MRI is accurate in staging extent of disease in the breast in patients with HG tumors.
authors.affiliation: Moore's Cancer Center, University of California San Diego, San Diego, California, USA. slblair@ucsd.edu
authors.forename: Sarah
authors.initials: S
authors.lastname: Blair
authors.forename: Michele
authors.initials: M
authors.lastname: McElroy
authors.forename: Michael S
authors.initials: MS
authors.lastname: Middleton
authors.forename: Chris
authors.initials: C
authors.lastname: Comstock
authors.forename: Tanya
authors.initials: T
authors.lastname: Wolfson
authors.forename: Mitch
authors.initials: M
authors.lastname: Kamrava
authors.forename: Anne
authors.initials: A
authors.lastname: Wallace
authors.forename: Joanne
authors.initials: J
authors.lastname: Mortimer
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies