MR-mammography – impact on disease extent determination and surgical treatment of invasive ductal and lobular breast cancers
Abstract:
The aim of this study is to assess the impact of multiparametric MR imaging to an exact determination of the extent of invasive ductal and lobular breast cancers in routine clinical practice.180 women aged 27-74 years (median 52.4 years) with newly diagnosed invasive ductal and lobular breast cancers confirmed by core-cut or vacuum-assisted biopsy were examined by all three imaging modalities, i.e. digital X-ray mammography, ultrasonography and 3T MR-mammography. In case of MR-mammography an extended protocol, i.e. combination of morphological breast MRI + DCE + DWI was used. For overall detection and determination of the extent of invasive breast cancers (IDC + ILC) MRmammography alone reached the diagnostic accuracy of 72.48%, while X-ray mammography 69.12% and ultrasonography 59.87%. In cases of ILC combination of X-ray mammography and MR- mammography with sensitivity of 96.15% was the most effective. In comparison with X-ray mammography and ultrasonography MR-mammography had higher sensitivity (96.15%, versus 90.28%) in the diagnosis of multifocal/ multicentric invasive lobular carcinoma and invasive ductal carcinoma with extensive intraductal component, as well. 3T MR-mammography is an effective complementary consulting modality to digital X-ray mammography and ultrasonography, and it is particularly beneficial in the detection of additional mammographically and ultrasonografically occult breast lesions, as well as in the determination of the real extent of pathological changes in the ipsilateral and contralateral breast.