CARIN Anne-Julie Centre hospitalier de Haguenau, 64 avenue du Professeur Leriche, 67500, Haguenau, France.
MOLIERE Sébastien MD Unité d'imagerie mammaire CHRU Hôpitaux universitaires de Strasbourg, Avenue Molière, 67200, Strasbourg, France.
World J Surg Oncol. 2017 Jul 14;15(1):128. doi: 10.1186/s12957-017-1197-1.
The aim of this study was the evaluation of breast MRI in determining the size and focality of invasive non-metastatic breast cancers.
The prospective, single-centre study conducted in 2015 compared preoperative MRI with histological analysis of mastectomy.
One hundred one mastectomies from 98 patients were extensively analysed. The rates of false-positive and false-negative MRI were 2 and 4% respectively. The sensitivity of breast MRI was 84.7% for the detection of all invasive foci, 69% for single foci and 65.7% for multiple foci. In the evaluation of tumour size, the Spearman rank correlation coefficient r between the sizes obtained by MRI and histology was 0.62. The MRI-based prediction of a complete response to neoadjuvant chemotherapy was 75%.
MRI exhibits high sensitivity in the detection of invasive breast cancers. False positives were linked to the inflammatory nature of the tumour bed. False negatives were associated with small or low-grade tumours and their retro-areolar location. The size of T1 tumours was overestimated by an average of 7%, but MRI was the most efficient procedure. The sensitivity of MRI for the diagnosis of unifocal tumours was higher than that for multifocal sites. Our study confirmed the positive contribution of preoperative MRI for invasive lobular carcinomas and complete response predictions after neoadjuvant chemotherapy.
本研究旨在评估乳腺 MRI 在确定浸润性非转移性乳腺癌的大小和局灶性方面的作用。
本前瞻性、单中心研究于 2015 年进行，将术前 MRI 与乳房切除术的组织学分析进行了比较。
对 98 例患者的 101 例乳房切除术进行了广泛分析。MRI 的假阳性和假阴性率分别为 2%和 4%。乳腺 MRI 检测所有浸润灶的灵敏度为 84.7%，单灶为 69%，多灶为 65.7%。在评估肿瘤大小方面，MRI 与组织学获得的大小之间的 Spearman 秩相关系数 r 为 0.62。MRI 预测新辅助化疗完全缓解的准确率为 75%。
MRI 在检测浸润性乳腺癌方面具有较高的灵敏度。假阳性与肿瘤床的炎症性质有关。假阴性与肿瘤体积小或分级低以及位于乳晕后有关。T1 期肿瘤的大小平均高估了 7%，但 MRI 是最有效的方法。MRI 对单灶肿瘤的诊断灵敏度高于多灶性肿瘤。本研究证实了术前 MRI 对浸润性小叶癌的积极作用，以及对新辅助化疗后完全缓解的预测作用。
