title: [Impact of preoperative breast magnetic resonance imaging on surgical management: experience of two university hospitals].
abstract: OBJECTIVE
  Breast magnetic resonance imaging (MRI) has attained a solid position in the diagnosis of breast cancer but its benefit is still to be confirmed in the preoperative staging. The authors assessed the impact of preoperative breast MRI on surgical management of breast cancer in two university hospitals.
  
  
  METHODS
  This retrospective review was realized in two university hospitals and concerned all patients with breast carcinoma who had a surgical first therapy. We selected 89 patients who underwent preoperative breast MRI in the period between January 2008 and December 2009.
  
  
  RESULTS
  The sensitivity of breast MRI for detecting breast tumor was 95%. Fourteen percent of patients had a multifocal disease, 10% a multicentric disease and 2% a synchronous bilateral cancer. The correlation of radiological tumor size with histopathological size was r=0.68 in IRM compared to r=0.45 in conventional imaging (P<0.001). Nineteen additional biopsies were performed and 9.9% of false-positive findings were detected. Retrospectively, planned surgical management was altered in 9% of patients, resulted from use of breast MRI. Six patients had conversion of planned breast conservation to mastectomy and two patients underwent contralateral lumpectomy after discover synchronous bilateral cancer.
  
  
  CONCLUSIONS
  Breast MRI was very sensitive for the detection of breast carcinoma and improved local staging in almost 9% of patients. But, low specificity of this imaging requires a systematically validation of additional lesions by biopsy before surgical planning.
authors.affiliation: Service de chirurgie gynécologique, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France; Faculté de médecine Henri-Warembourg, université Lille-2, 1, place Verdun, 59000 Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Lafaye-Carré
authors.affiliation: Service de chirurgie gynécologique, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Collinet
authors.affiliation: Service de chirurgie gynécologique, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Vinatier
authors.affiliation: Service de radiologie, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, avenue de Verdun, 75010 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Bendavid
authors.affiliation: Service de radiologie, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, avenue de Verdun, 75010 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Place
authors.affiliation: Service de radiologie, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Pruvo
authors.affiliation: Service de radiologie, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
authors.forename: N
authors.initials: N
authors.lastname: Faye
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 10, avenue de Verdun, 75010 Paris, France; Service de gynécologie-obstétrique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France; Département de chirurgie oncologique, pôle de chirurgie oncologique, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2, France. Electronic address: emmanuel.barranger@nice.unicancer.fr.
authors.forename: E
authors.initials: E
authors.lastname: Barranger
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005189:False Positive Reactions; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008279:Magnetic Resonance Imaging; D008408:Mastectomy / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Bilan préopératoire; Breast MRI; Breast cancer; Breast surgery; Cancer du sein; Chirurgie mammaire; IRM mammaire; Staging