title: [Whole-body MRI in preoperative diagnostics of breast cancer--a comparison with [corrected] staging methods according to the S 3 guidelines].
abstract: OBJECTIVE
  The German Society of Senology (step-3 guidelines for the early recognition of breast cancer in Germany) recommends whole-body staging including chest X-ray, ultrasound of the liver and bone scintigraphy before systemic therapy in patients with breast cancer. The performance of these three examinations is time-consuming and involves radiation exposure. Whole-body MR imaging (WB-MRI) allows staging in a single examination without radiation exposure. The purpose of this study was to compare the diagnostic accuracy of WB-MRI with staging according to the guidelines.
  
  
  METHODS
  During 04/07 and 06/09, the initial staging in 51 patients (56 ± 12 yrs) with breast cancer (24 patients with lymph node metastases) was performed according to the S 3-guidelines. Additionally, all patients underwent contrast-enhanced WB-MRI (1.5-Tesla-Magnetom Avanto, Siemens, Erlangen). The findings of the different modalities were compared after correlation of the lesions by follow-up. The detection of suspicious findings and the accuracy of prediction of malignancy of the detected lesions were evaluated.
  
  
  RESULTS
  Overall, 14 metastases were detected in 4 of 51 patients after completion of the follow-up. By means of WB-MRI, all 14 metastases could be detected, while just 4 of these metastases were identified by the conventional methods.
  
  
  CONCLUSIONS
  The detection of distant metastases has an important impact on patient management. In this study WB-MRI in breast cancer staging has shown promising results in regard to possible clinical implementation as a matter of routine staging.
authors: Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Universität Heidelberg. daniel.hausmann@umm.de
authors: D
authors: D
authors: Hausmann
authors: C
authors: C
authors: Kern
authors: M T
authors: MT
authors: Schröder
authors: M
authors: M
authors: Sütterlin
authors: S O
authors: SO
authors: Schönberg
authors: K W
authors: KW
authors: Neff
authors: D J
authors: DJ
authors: Dinter
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008207:Lymphatic Metastasis / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D012680:Sensitivity and Specificity; D051598:Whole Body Imaging / Q000379:methods*