title: Enhancing patterns of breast cancer on preoperative dynamic contrast-enhanced magnetic resonance imaging and resection margin in breast conserving therapy.
abstract: BACKGROUND
  The association between enhancing patterns of preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and resection margins after BCS has not been studied in detail before.
  
  
  OBJECTIVE
  We investigated the association between surgical outcomes and enhancing patterns observed on DCE-MRI.
  
  
  METHODS
  269 enhancing patterns on DCE-MRI scans were selected, and subdivided into the following groups: (1) a single mass-like enhancement, (2) a single non-mass-like enhancement (NME), (3) mass-like enhancing breast cancer with other mass-like enhancing lesions, and (4) mass-like enhancing breast cancer with additional NMEs. Associations between enhancing patterns on DCE-MRI and re-excision rate, size of specimen, and ratio of tumor/specimen were evaluated retrospectively.
  
  
  RESULTS
  The conversion rate from breast conserving therapy (BCT) to mastectomy as a result of MRI findings was 13.4%, re-excision rate during BCT was 8.2% and excision rate of another suspicious lesion was 7.4%. The single NME group had the highest re-excision rate after BCT (22.2%) (p = 0.02). The ratio of tumor/specimen (p = 0.61) and mean specimen size (p = 0.38) were not influenced by enhancement patterns. The false positive rate and positive predictive values of using DCE-MRI for defining the extension of breast cancer was 22.2% and 71.4%, respectively.
  
  
  CONCLUSIONS
  Enhancement patterns on DCE- MRI, especially NME, could increase re-excision rates.
authors.affiliation: Department of Diagnostic Radiology, College of Medicine, Sungkyunkwan University, Samsungchangwon hospital, Changwon, Korea.
authors.forename: Ok Hwa
authors.initials: OH
authors.lastname: Kim
authors.affiliation: Department of Diagnostic Radiology, College of Medicine, Inje University, Busan, Korea.
authors.forename: Suk Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea.
authors.forename: Jung Sun
authors.initials: JS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000071960:Breast Carcinoma In Situ / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D000072662:Margins of Excision; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D057234:Preoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D047368:Tumor Burden
chemical_list: D003287:Contrast Media
keywords: Breast neoplasm; breast conserving therapy; magnetic resonance imaging (MRI); mass; non-mass-like enhancement; re-excision