The Predictive Value of Second-Look Ultrasound after Preoperative Breast Magnetic Resonance Imaging
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Purpose: The purpose of the current study was to evaluate the usefulness of second-look ultrasonography (US) for evaluating incidental enhancing lesions identified on preoperative breast magnetic resonance imaging (MRI) performed to stage malignant lesions. Methods: We studied 88 patients with suspected breast malignancy on conventional mammography and/or whole-breast US and invasive carcinoma subsequently confirmed by cytology or core biopsy, who underwent preoperative breast MRI for accurate breast cancer staging between January 2011 and July 2014. Patients’ demographic, clinical and pathological characteristics were assessed. Results: Seven hundred forty-nine patients underwent preoperative breast MRI, and the imaging detected incidental enhancing lesions in 257 patients. Second-look US was performed to evaluate 126 incidental enhancing lesions in 88 patients. We evaluated the frequency of malignancy as a function of lesion size on MRI, lesion size on second-look US, menstrual status, and age. The frequency of malignancy was higher for lesions 0.6 cm or larger on MRI than for smaller lesions (25.9% vs. 0%), and this difference was statistically significant (p=0.032). Conclusion: In conclusion, we found that the frequency of malignancy increased with the size of incidental enhancing lesions detected by MRI. On the basis of our results, biopsy is warranted in cases of incidental enhancing lesions 0.6 cm or larger on MRI. Further study with a larger series of cases and including more detailed subgroup analyses is necessary to develop reliable management guidelines for these lesions.
Abstract
Purpose: The purpose of the current study was to evaluate the usefulness of second-look ultrasonography (US) for evaluating incidental enhancing lesions identified on preoperative breast magnetic resonance imaging (MRI) performed to stage malignant lesions. Methods: We studied 88 patients with suspected breast malignancy on conventional mammography and/or whole-breast US and invasive carcinoma subsequently confirmed by cytology or core biopsy, who underwent preoperative breast MRI for accurate breast cancer staging between January 2011 and July 2014. Patients’ demographic, clinical and pathological characteristics were assessed. Results: Seven hundred forty-nine patients underwent preoperative breast MRI, and the imaging detected incidental enhancing lesions in 257 patients. Second-look US was performed to evaluate 126 incidental enhancing lesions in 88 patients. We evaluated the frequency of malignancy as a function of lesion size on MRI, lesion size on second-look US, menstrual status, and age. The frequency of malignancy was higher for lesions 0.6 cm or larger on MRI than for smaller lesions (25.9% vs. 0%), and this difference was statistically significant (p=0.032). Conclusion: In conclusion, we found that the frequency of malignancy increased with the size of incidental enhancing lesions detected by MRI. On the basis of our results, biopsy is warranted in cases of incidental enhancing lesions 0.6 cm or larger on MRI. Further study with a larger series of cases and including more detailed subgroup analyses is necessary to develop reliable management guidelines for these lesions.
참고문헌 (13)
- Li CI, "Clinical characteristics of different histologic types of breast cancer", Br J Cancer, 93, pp.1046~1052 (2005)
- Li CI, "Trends in incidence rates of invasive lobular and ductal breast carcinoma", JAMA, 289, pp.1421~1424 (2003)
- Luciani ML, "Incidental enhancing lesions found on preoperative breast MRI: management and role of second-look ultrasound", Radiol Med, 116, pp.886~904 (2011)
- Fausto A, "Clinical value of second-look ultrasound: is there a way to make it objective?", Eur J Radiol, 81(Suppl 1), pp.S36~S40 (2012)
- Slanetz PJ, "Occult contralateral breast carcinoma incidentally detected by breast magnetic resonance imaging", Breast J, 8, pp.145~148 (2002)
- Lee SG, "MR imaging screening of the contralateral breast in patients with newly diagnosed breast cancer: preliminary results", Radiology, 226, pp.773~778 (2003)
- Viehweg P, "MR imaging of the contralateral breast in patients after breast-conserving therapy", Eur Radiol, 14, pp.402~408 (2004)
- Liberman L, "MR imaging findings in the contralateral breast of women with recently diagnosed breast cancer", AJR Am J Roentgenol, 180, pp.333~341 (2003)
- Linda A, "Outcome of initially only magnetic resonance mammography-detected findings with and without correlate at second-look sonography: distribution according to patient history of breast cancer and lesion size", Breast, 17, pp.51~57 (2008)
- Liberman L, "Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size", AJR Am J Roentgenol, 186, pp.426~430 (2006)
- Carbognin G, "Utility of second-look ultrasound in the management of incidental enhancing lesions detected by breast MR imaging", Radiol Med, 115, pp.1234~1245 (2010)
- Demartini WB, "Utility of targeted sonography for breast lesions that were suspicious on MRI", AJR Am J Roentgenol, 192, pp.1128~1134 (2009)
- Abe H, "MR-directed (“Second-Look”) ultrasound examination for breast lesions detected initially on MRI: MR and sonographic findings", AJR Am J Roentgenol, 194, pp.370~377 (2010)