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Potential impact of preoperative magnetic resonance imaging of the breast on patient selection for accelerated partial breast irradiation.
Int J Radiat Oncol Biol Phys. 2011 Nov 15; 81(4):e541-6.IJ

Abstract

PURPOSE

Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI.

METHODS AND MATERIALS

From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size ≤3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget's disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI.

RESULTS

MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally.

CONCLUSIONS

Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

Authors+Show Affiliations

Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn, Germany. marietta.kuehr@ukb.uni-bonn.deNo affiliation info availableNo 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)

Evaluation Study
Journal Article

Language

eng

PubMed ID

21664064

Citation

Kühr, Marietta, et al. "Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast On Patient Selection for Accelerated Partial Breast Irradiation." International Journal of Radiation Oncology, Biology, Physics, vol. 81, no. 4, 2011, pp. e541-6.
Kühr M, Wolfgarten M, Stölzle M, et al. Potential impact of preoperative magnetic resonance imaging of the breast on patient selection for accelerated partial breast irradiation. Int J Radiat Oncol Biol Phys. 2011;81(4):e541-6.
Kühr, M., Wolfgarten, M., Stölzle, M., Leutner, C., Höller, T., Schrading, S., Kuhl, C., Schild, H., Kuhn, W., & Braun, M. (2011). Potential impact of preoperative magnetic resonance imaging of the breast on patient selection for accelerated partial breast irradiation. International Journal of Radiation Oncology, Biology, Physics, 81(4), e541-6. https://doi.org/10.1016/j.ijrobp.2011.04.035
Kühr M, et al. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast On Patient Selection for Accelerated Partial Breast Irradiation. Int J Radiat Oncol Biol Phys. 2011 Nov 15;81(4):e541-6. PubMed PMID: 21664064.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potential impact of preoperative magnetic resonance imaging of the breast on patient selection for accelerated partial breast irradiation. AU - Kühr,Marietta, AU - Wolfgarten,Matthias, AU - Stölzle,Marco, AU - Leutner,Claudia, AU - Höller,Tobias, AU - Schrading,Simone, AU - Kuhl,Christiane, AU - Schild,Hans, AU - Kuhn,Walther, AU - Braun,Michael, Y1 - 2011/06/12/ PY - 2010/10/27/received PY - 2011/04/14/revised PY - 2011/04/19/accepted PY - 2011/6/14/entrez PY - 2011/6/15/pubmed PY - 2012/1/10/medline SP - e541 EP - 6 JF - International journal of radiation oncology, biology, physics JO - Int J Radiat Oncol Biol Phys VL - 81 IS - 4 N2 - PURPOSE: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. METHODS AND MATERIALS: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size ≤3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget's disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. RESULTS: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. CONCLUSIONS: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI. SN - 1879-355X UR - https://www.unboundmedicine.com/medline/citation/21664064/Potential_impact_of_preoperative_magnetic_resonance_imaging_of_the_breast_on_patient_selection_for_accelerated_partial_breast_irradiation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(11)00556-6 DB - PRIME DP - Unbound Medicine ER -