title: Breast cancer preoperative staging: does contrast-enhanced magnetic resonance mammography modify surgery?
abstract: Women with newly diagnosed breast cancer may have lesions undetected by conventional imaging. Recently contrast-enhanced magnetic resonance mammography (CE-MRM) showed higher sensitivity in breast lesions detection. The present analysis was aimed at evaluating the benefit of preoperative CE-MRM in the surgical planning. From 2005 to 2009, 525 consecutive women (25-75 years) with breast cancer, newly diagnosed by mammography, ultrasound, and needle-biopsy, underwent CE-MRM. The median invasive tumour size was 19 mm. In 144 patients, CE-MRM identified additional lesions. After secondlook, 119 patients underwent additional biopsy. CE-MRM altered surgery in 118 patients: 57 received double lumpectomy or wider excision (41 beneficial), 41 required mastectomy (40 beneficial), and 20 underwent contra lateral surgery (18 beneficial). The overall false-positive rate was 27.1% (39/144). CE-MRM contributed significantly to the management of breast cancer, suggesting more extensive disease in 144/525 (27.4%) patients and changing the surgical plan in 118/525 (22.5%) patients (99/525, 18.8% beneficial).
authors.affiliation: Ginteam, Mini-Invasive Gynaecological and Breast Surgery Unit, Evangelical Hospital, ASL TO1, Via Silvio Pellico 19, 10125 Torino, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Perono Biacchiardi
authors.forename: Davide
authors.initials: D
authors.lastname: Brizzi
authors.forename: Franco
authors.initials: F
authors.lastname: Genta
authors.forename: Eugenio
authors.initials: E
authors.lastname: Zanon
authors.forename: Marco
authors.initials: M
authors.lastname: Camanni
authors.forename: Francesco
authors.initials: F
authors.lastname: Deltetto