Enhancing patterns of breast cancer on preoperative dynamic contrast-enhanced magnetic resonance imaging and resection margin in breast conserving therapy

Article type: Research Article

Authors: Kim, Ok Hwa^a | Kim, Suk Jung^b | Lee, Jung Sun^{c; *}

Affiliations: [a] Department of Diagnostic Radiology, College of Medicine, Sungkyunkwan University, Samsungchangwon hospital, Changwon, Korea | [b] Department of Diagnostic Radiology, College of Medicine, Inje University, Busan, Korea | [c] Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea

Correspondence: [*] Corresponding author: Jung Sun Lee, Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea. Tel.: +82 51 797 0695; Fax: +82 51 797 0280; E-mail: gsjslee@gmail.com

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. CONCLUSION:Enhancement patterns on DCE- MRI, especially NME, could increase re-excision rates.

Keywords: Breast neoplasm, magnetic resonance imaging (MRI), non-mass-like enhancement, mass, breast conserving therapy, re-excision

DOI: 10.3233/BD-150195

Journal: Breast Disease, vol. 36, no. 1, pp. 27-35, 2016