J Breast Cancer.  2011 Sep;14(3):213-218.

Clinical Outcome of Magnetic Resonance Imaging-Detected Additional Lesions in Breast Cancer Patients

• Ha GW
• Yi MS
• Lee BK
• Youn HJ
• Jung SH

Abstract

PURPOSE
The aim of this study was to investigate the clinical outcome of additional breast lesions identified with breast magnetic resonance imaging (MRI) in breast cancer patients.
METHODS
A total of 153 patients who underwent breast MRI between July 2006 and March 2008 were retrospectively reviewed. Thirty-three patients (21.6&) were recommended for second-look ultrasound (US) for further characterization of additional lesions detected on breast MRI and these patients constituted our study population.
RESULTS
Assessment for lesions detected on breast MRI consisted of the following: 25 benign lesions (73.5&), two indeterminate (5.9%), and seven malignant (20.6%) in 33 patients. Second-look US identified 12 additional lesions in 34 lesions (35.3%) and these lesions were confirmed by histological examination. Of the 12 lesions found in the 11 patients, six (50.0%) including one contralateral breast cancer were malignant. The surgical plan was altered in 18.2% (six of 33) of the patients. The use of breast MRI justified a change in treatment for four patients (66.7%) and caused two patients (33.3&) to undergo unwarranted additional surgical procedures.
CONCLUSION
Breast MRI identified additional multifocal or contralateral cancer which was not detected initially on conventional imaging in breast cancer patients. Breast MRI has become an indispensable modality in conjunction with conventional modalities for preoperative evaluation of patients with operable breast cancer.

Keyword

Breast neoplasms; Magnetic resonance imaging; Ultrasonography

MeSH Terms

Breast
Breast Neoplasms
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Retrospective Studies

Figure

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  Figure 1 Assessment and pathologic results of additional lesions on magnetic resonance imaging (MRI). Additional 34 lesions on breast MRI were found in 33 patients. Twenty-two lesions which were assessed as benign lesion on breast MRI were not identified the additional lesions on second-look ultrasound (US). Twelve additional lesions in 11 patients have been diagnosed as follows. *One patient has two malignant assessed lesions in each breast.

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  Figure 2 A 59-year-old woman with known right breast cancer (4-o'clock position) who underwent preoperative breast magnetic resonance imaging (MRI). (A) Subtraction axial MR image shows unexpected oval shaped enhancing lesion (arrow) at 3-o'clock position in the right breast. It was classified as malignant. (B) On second-look ultrasound, 0.7 cm sized, oval, ill defined, and hypoechoic lesion was found at the identical location. Sonographic findings suggest BI-RADS 4C and pathologic result was invasive ductal carcinoma.

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