Bedrosian Isabelle, Mick Rosemarie, Orel Susan G, Schnall Mitchell, Reynolds Carol, Spitz Francis R, Callans Linda S, Buzby Gordon P, Rosato Ernest F, Fraker Douglas L, Czerniecki Brian J
Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Cancer. 2003 Aug 1;98(3):468-73. doi: 10.1002/cncr.11490.
Breast magnetic resonance imaging (MRI) is a developing technique for the evaluation of patients with primary breast carcinoma. The authors assessed the impact of preoperative breast MRI on surgical management.
The current study was a retrospective review of 267 patients with primary breast tumors who had MRI studies prior to undergoing definitive surgery.
Two hundred sixty-seven patients with invasive breast carcinoma who had preoperative breast MRI studies and had complete clinical, radiologic, and pathologic data available were identified and formed the basis of this analysis. The overall sensitivity of MRI for detecting primary, intact breast tumors was 95%. Planned surgical management was altered in 69 of 267 patients (26%); and, in 49 of those patients (71%), there was pathologic verification of malignancy in the surgical specimen that confirmed the need for wider or separate excision or mastectomy. Forty-four of 267 patients (16.5%) had conversion of planned breast conservation to mastectomy. In a univariate analysis, change in management was associated significantly with histology; management was altered in 11 of 24 lobular tumors (46%) compared with 58 of 243 ductal tumors (24%; P = 0.02).
Breast MRI was very sensitive for the detection of primary, intact, invasive breast carcinoma and improved local staging in almost 20% of patients. Preoperative breast MRI studies may be particularly useful in surgical planning for and management of patients with lobular carcinoma.
乳腺磁共振成像（MRI）是一种用于评估原发性乳腺癌患者的发展中的技术。作者评估了术前乳腺MRI对手术管理的影响。
本研究是对267例原发性乳腺肿瘤患者进行的回顾性研究，这些患者在接受确定性手术前进行了MRI检查。
确定了267例术前进行乳腺MRI检查且有完整临床、放射学和病理学数据的浸润性乳腺癌患者，并以此作为本分析的基础。MRI检测原发性完整乳腺肿瘤的总体敏感性为95%。267例患者中有69例（26%）的计划手术管理发生了改变；其中49例（71%）手术标本中有恶性肿瘤的病理证实，这证实了需要更广泛或单独切除或乳房切除术。267例患者中有44例（16.5%）计划的保乳手术改为乳房切除术。在单因素分析中，管理方式的改变与组织学显著相关；24例小叶癌中有11例（46%）管理方式发生改变，而243例导管癌中有58例（24%）管理方式发生改变（P = 0.02）。
乳腺MRI对检测原发性、完整的浸润性乳腺癌非常敏感，几乎在20%的患者中改善了局部分期。术前乳腺MRI检查在小叶癌患者的手术规划和管理中可能特别有用。
