title: Preoperative breast magnetic resonance imaging: applications in clinical practice.
abstract: Results of large randomized trials have shown that survival rates after breast conserving surgery are equivalent to those obtained by radical mastectomy. Breast conserving surgery with wide local excision in women with early stage breast cancer who are thought to have a single and resectable tumour as determined by clinical examination and conventional imaging followed by postoperative irradiation is the standard of care in early breast cancer. Mapping of local disease is the key element to guide optimal surgery to obtain tumour-free margins, thereby decreasing risk of local recurrence. The usual preoperative workup of breast malignancy consists of clinical breast examination and mammography with or without ultrasound. However, mammography and ultrasound fail to accurately assess tumour extent in as many as a third of patients eligible for breast conserving therapy. It is well established that magnetic resonance imaging is far superior to mammography (with and without ultrasound) for mapping the local extent of breast cancer. Experts advocate its use despite its high costs, high number of false positive findings, and lack of evidence from randomized prospective trials and, notably, fear of "overtreatment." This article discusses the current role of breast magnetic resonance imaging with its clinical advantages and applications.
authors.affiliation: Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women’s College Hospital, Princess Margaret Hospital 3-976, 610 University Ave, Toronto, Ontario M5G2M9, Canada. supriya.kulkarni@uhn.on.ca
authors.forename: Supriya
authors.initials: S
authors.lastname: Kulkarni
authors.forename: Nitin
authors.initials: N
authors.lastname: Singh
authors.forename: Pavel
authors.initials: P
authors.lastname: Crystal
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011300:Preoperative Care; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation; D012680:Sensitivity and Specificity; D015996:Survival Rate