Tags

Type your tag names separated by a space and hit enter

Use of preoperative magnetic resonance imaging for invasive lobular cancer: good, better, but maybe not the best?
Ann Surg Oncol. 2010 Oct; 17 Suppl 3:255-62.AS

Abstract

BACKGROUND

Invasive lobular cancer (ILC) of the breast is difficult to diagnose clinically and radiologically. It is hoped that preoperative magnetic resonance imaging (MRI) can improve evaluation of extent of disease.

METHODS

Patients diagnosed with ILC at a single institution from 2001 to 2008 who underwent clinical breast examination (CBE), mammography, ultrasound, and MRI were studied retrospectively. Concordance between tumor size on imaging/CBE and pathologic size was defined as size within ± 0.5 cm. Pearson correlation coefficients (R) were calculated for each modality. Local recurrence and re-excision rates were compared with those patients with ILC who did not undergo preoperative MRI.

RESULTS

Seventy patients with ILC had all imaging modalities, including CBE, performed preoperatively. The sensitivity for detection of ILC by MRI was 99%. MRI-based tumor size was concordant with pathologic tumor size in 56% of tumors. MRI overestimated tumor size by >0.5 cm in 31% of tumors. Correlation of tumor size on imaging with final pathology was better for MRI (R = 0.75) than for mammography (R = 0.65), CBE (R = 0.63), or ultrasound (R = 0.45, all P < 0.01). Preoperative MRI was associated with lower reoperation rates for close/positive margins (P > 0.05).

CONCLUSIONS

For ILC, MRI has better sensitivity of detection and correlation with tumor size at pathology than CBE, mammography, or ultrasound. However, 31% of cases are overestimated by MRI, and correlation remains only at 0.75. The select use of MRI for preoperative estimation of tumor size in ILC is supported by our data, but the need for improvement and refinement of imaging remains.

Authors+Show Affiliations

Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20853043

Citation

McGhan, Lee J., et al. "Use of Preoperative Magnetic Resonance Imaging for Invasive Lobular Cancer: Good, Better, but Maybe Not the Best?" Annals of Surgical Oncology, vol. 17 Suppl 3, 2010, pp. 255-62.
McGhan LJ, Wasif N, Gray RJ, et al. Use of preoperative magnetic resonance imaging for invasive lobular cancer: good, better, but maybe not the best? Ann Surg Oncol. 2010;17 Suppl 3:255-62.
McGhan, L. J., Wasif, N., Gray, R. J., Giurescu, M. E., Pizzitola, V. J., Lorans, R., Ocal, I. T., Stucky, C. C., & Pockaj, B. A. (2010). Use of preoperative magnetic resonance imaging for invasive lobular cancer: good, better, but maybe not the best? Annals of Surgical Oncology, 17 Suppl 3, 255-62. https://doi.org/10.1245/s10434-010-1266-y
McGhan LJ, et al. Use of Preoperative Magnetic Resonance Imaging for Invasive Lobular Cancer: Good, Better, but Maybe Not the Best. Ann Surg Oncol. 2010;17 Suppl 3:255-62. PubMed PMID: 20853043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of preoperative magnetic resonance imaging for invasive lobular cancer: good, better, but maybe not the best? AU - McGhan,Lee J, AU - Wasif,Nabil, AU - Gray,Richard J, AU - Giurescu,Marina E, AU - Pizzitola,Victor J, AU - Lorans,Roxanne, AU - Ocal,Idris T, AU - Stucky,Chee-Chee H, AU - Pockaj,Barbara A, Y1 - 2010/09/19/ PY - 2010/04/26/received PY - 2010/9/21/entrez PY - 2010/10/1/pubmed PY - 2011/1/12/medline SP - 255 EP - 62 JF - Annals of surgical oncology JO - Ann Surg Oncol VL - 17 Suppl 3 N2 - BACKGROUND: Invasive lobular cancer (ILC) of the breast is difficult to diagnose clinically and radiologically. It is hoped that preoperative magnetic resonance imaging (MRI) can improve evaluation of extent of disease. METHODS: Patients diagnosed with ILC at a single institution from 2001 to 2008 who underwent clinical breast examination (CBE), mammography, ultrasound, and MRI were studied retrospectively. Concordance between tumor size on imaging/CBE and pathologic size was defined as size within ± 0.5 cm. Pearson correlation coefficients (R) were calculated for each modality. Local recurrence and re-excision rates were compared with those patients with ILC who did not undergo preoperative MRI. RESULTS: Seventy patients with ILC had all imaging modalities, including CBE, performed preoperatively. The sensitivity for detection of ILC by MRI was 99%. MRI-based tumor size was concordant with pathologic tumor size in 56% of tumors. MRI overestimated tumor size by >0.5 cm in 31% of tumors. Correlation of tumor size on imaging with final pathology was better for MRI (R = 0.75) than for mammography (R = 0.65), CBE (R = 0.63), or ultrasound (R = 0.45, all P < 0.01). Preoperative MRI was associated with lower reoperation rates for close/positive margins (P > 0.05). CONCLUSIONS: For ILC, MRI has better sensitivity of detection and correlation with tumor size at pathology than CBE, mammography, or ultrasound. However, 31% of cases are overestimated by MRI, and correlation remains only at 0.75. The select use of MRI for preoperative estimation of tumor size in ILC is supported by our data, but the need for improvement and refinement of imaging remains. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/20853043/Use_of_preoperative_magnetic_resonance_imaging_for_invasive_lobular_cancer:_good_better_but_maybe_not_the_best L2 - https://dx.doi.org/10.1245/s10434-010-1266-y DB - PRIME DP - Unbound Medicine ER -