Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Biomedical Photonic Imaging Group, MIRA Institute, University of Twente, 217, 7500 AE, Enschede, The Netherlands.
Breast Cancer Res Treat. 2018 Jun;169(3):513-522. doi: 10.1007/s10549-018-4706-1. Epub 2018 Feb 13.
To investigate the clinical utility of molecular breast imaging (MBI) in patients with proven invasive breast cancer scheduled for breast-conserving surgery (BCS).
Following approval by the institutional review board and written informed consent, records of patients with newly diagnosed breast cancer scheduled for BCS who had undergone MBI for local staging in the period from March 2012 till December 2014 were retrospectively reviewed.
A total of 287 women (aged 30-88 years) were evaluated. MBI showed T stage migration in 26 patients (9%), with frequent detection of in situ carcinoma around the tumor. Surgical management was adjusted in 14 of these patients (54%). In 17 of 287 patients (6%), MBI revealed 21 proven additional lesions in the ipsilateral, contralateral breast or both. In 18 of these additional foci (86%), detected in 15 patients, malignancy was found. Thirteen of these 15 patients had ipsilateral cancer and 2 patients bilateral malignancy. In total, MBI revealed a larger tumor extent, additional tumor foci or both in 40 patients (14%), leading to treatment adjustment in 25 patients (9%).
MBI seems to be a useful imaging modality with a high predictive value in revealing ipsilateral and bilateral disease not visualized by mammography and ultrasound. It may play an important role in delineating the extent of the index lesion during preoperative planning. Incorporation of MBI in the clinical work-up as an adjunct modality to mammography and ultrasound may lead to better selection of patients who could benefit from BCS.
探讨分子乳腺成像（MBI）在拟行保乳手术（BCS）的浸润性乳腺癌患者中的临床应用价值。
经机构审查委员会批准并获得书面知情同意后，回顾性分析了 2012 年 3 月至 2014 年 12 月期间因局部分期而接受 MBI 的新诊断为乳腺癌且拟行 BCS 的患者的病历。
共评估了 287 名女性（年龄 30-88 岁）。MBI 显示 26 例（9%）患者 T 分期迁移，肿瘤周围常检测到原位癌。其中 14 例（54%）患者的手术管理进行了调整。在 287 例患者中（6%），17 例患者同侧、对侧或双侧乳腺发现 21 例经证实的附加病变。在这 21 个附加病灶中，18 个（86%）在 15 例患者中发现恶性肿瘤。这 15 例患者中有 13 例为同侧癌，2 例为双侧恶性肿瘤。总之，MBI 显示 40 例（14%）患者肿瘤范围更大、肿瘤病灶更多或两者兼而有之，导致 25 例（9%）患者的治疗方案调整。
MBI 似乎是一种有用的成像方式，具有较高的预测价值，可发现乳腺 X 线摄影和超声未显示的同侧和双侧疾病。它可能在术前计划中对描绘指数病变的范围发挥重要作用。将 MBI 纳入临床评估作为乳腺 X 线摄影和超声的辅助手段，可能会更好地选择可以从 BCS 中获益的患者。
