Department of Surgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea.
Department of Radiology, Kyungpook National University, School of Medicine, Daegu, Republic of Korea.
J Surg Oncol. 2016 Jan;113(1):12-6. doi: 10.1002/jso.24102. Epub 2015 Dec 2.
Several reliable randomized studies do not recommend routine preoperative breast MR imaging for patients with breast cancer. However, because the principle of MR imaging is based on the dynamics of contrast enhancement, a specific biologic subgroup of tumors should sensitively respond to the imaging process.
From 2008 to 2013, 918 eligible patients with breast cancer underwent breast surgery and were divided into two groups based on preoperative breast MR findings: patients in whom the surgical plan was changed and those in whom the surgical plan remained unchanged. We investigated the changing patterns of breast surgery based on routine mammography, ultrasound, and preoperative breast magnetic resonance (MR) findings and analyzed the association between additional suspicious lesions on breast MR imaging and clinicopathologic factors.
Additional suspicious breast lesions were detected on preoperative MR imaging in 104 cases (11.3%), and the surgical strategy was changed as the final decision in 97 cases (10.6%). There was no difference between oncologic results between two groups. However, the triple-negative breast cancer (TNBC) was significantly associated with changing of the surgical strategy based on breast MR findings (P = 0.048).
Additional preoperative breast MR imaging may be helpful in surgical decision for patients with TNBC.
几项可靠的随机研究不建议常规对乳腺癌患者进行术前乳腺磁共振成像。然而，由于磁共振成像的原理基于对比增强的动力学，因此肿瘤的特定生物学亚组应该能够对成像过程产生敏感的反应。
2008 年至 2013 年，918 名符合条件的乳腺癌患者接受了乳腺手术，并根据术前乳腺磁共振成像结果分为两组：手术计划改变的患者和手术计划未改变的患者。我们根据常规乳腺 X 线摄影、超声和术前乳腺磁共振成像的结果，调查了乳腺手术的变化模式，并分析了乳腺磁共振成像上额外可疑病变与临床病理因素之间的关系。
术前磁共振成像检测到 104 例（11.3%）额外的可疑乳腺病变，其中 97 例（10.6%）作为最终决策改变了手术策略。两组之间的肿瘤学结果没有差异。然而，三阴性乳腺癌（TNBC）与基于乳腺磁共振成像结果改变手术策略显著相关（P=0.048）。
术前额外的乳腺磁共振成像可能有助于 TNBC 患者的手术决策。
