title: Breast-conserving surgery using supine magnetic resonance imaging in breast cancer patients receiving neoadjuvant chemotherapy.
abstract: BACKGROUND
  Success of breast-conserving surgery (BCS) following neoadjuvant chemotherapy (NAC) depends on accurate assessment of the initial lesion. We developed a new procedure (NIPR) in which initial naked magnetic resonance images are projected onto the skin before BCS.
  
  
  METHODS
  Thirty-five breast cancer patients underwent supine oblique MRI of the operative area. In 20 DCIS patients, the metallic clips were reproduced by projection on the skin using NIPR, and discrepancies between the projection site and clip were measured on X-rays. Fifteen patients (T1;3,T2;8,T3;4 cases) treated with NIPR were compared to 20 (T1;5 , T2;15 cases) treated using the conventional method with regard to excision area and additional excision rate of BCS after NAC.
  
  
  RESULTS
  The median discrepancy (linear distance) was 2.6 mm. NIPR significantly reduced the excision area and additional excision rate in T1 and T2 compared to the conventional method (P<0.05).
  
  
  CONCLUSIONS
  NIPR is a reliable technique for BCS following NAC with significant reductions in excision area and additional excision rate and superior cosmetic results.
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan. rikiya@graduate.chiba-u.jp
authors.forename: Rikiya
authors.initials: R
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagashima
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sakakibara
authors.forename: Takafumi
authors.initials: T
authors.lastname: Sangai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujimoto
authors.forename: Manabu
authors.initials: M
authors.lastname: Arai
authors.forename: Takashi
authors.initials: T
authors.lastname: Shida
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kaneoya
authors.forename: Takuya
authors.initials: T
authors.lastname: Ueda
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakatani
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D016683:Supine Position