Hollingsworth Alan B, Stough Rebecca G, O'Dell Carol A, Brekke Charles E
Department of Surgery, Mercy Health Center, Oklahoma City, OK, USA.
Am J Surg. 2008 Sep;196(3):389-97. doi: 10.1016/j.amjsurg.2007.10.009. Epub 2008 Apr 23.
Breast magnetic resonance imaging (MRI) has been recommended increasingly in the preoperative setting for patients newly diagnosed with malignancy to evaluate tumor extent, multicentricity, and contralateral disease.
Results of conventional imaging, breast MRI, and pathology were analyzed from 603 consecutive breast cancer patients who underwent MRI preoperatively. The focus of this retrospective study was imaging-histologic correlation.
Reoperation for positive margins after lumpectomy occurred in 8.8% of patients. Multicentricity was identified by MRI alone in 7.7% of patients, whereas 3.7% were found to have contralateral cancer by MRI. The sensitivity of MRI was 93% in detecting multicentric disease and 88% for contralateral disease, whereas sensitivity for conventional imaging was 46% and 19%, respectively. Unsuspected disease was identified by MRI equally for invasive ductal and ductal carcinoma in situ histology, whereas multicentricity was found more frequently with invasive lobular carcinoma.
Breast MRI is recommended for preoperative evaluation of the newly diagnosed breast cancer patient.
对于新诊断为恶性肿瘤的患者，术前越来越推荐使用乳腺磁共振成像（MRI）来评估肿瘤范围、多中心性和对侧疾病。
分析了603例术前接受MRI检查的连续乳腺癌患者的传统影像学、乳腺MRI和病理学结果。这项回顾性研究的重点是影像学与组织学的相关性。
8.8%的患者在乳房肿瘤切除术后因切缘阳性而接受再次手术。仅通过MRI发现7.7%的患者存在多中心性，而通过MRI发现3.7%的患者患有对侧癌。MRI检测多中心疾病的敏感性为93%，检测对侧疾病的敏感性为88%，而传统影像学的敏感性分别为46%和19%。MRI对浸润性导管癌和原位导管癌组织学中未被怀疑的疾病检出率相同，而多中心性在浸润性小叶癌中更常见。
推荐对新诊断的乳腺癌患者进行术前乳腺MRI评估。
