User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

The impact of breast MRI workup on tumor size assessment and surgical planning in patients with early breast cancer.

Primary tabs

Pop, Catalin-Florin Stanciu-Pop, Claudia [UCL] Drisis, Stylianos Radermeker, Magali Vandemerckt, Carine Veys, Isabelle

(eng) BACKGROUND: The size and focality of the primary tumor in breast cancer (BC) influence therapeutic decision making. The purpose of this study was to evaluate whether preoperative breast magnetic resonance imaging (MRI) is helpful for the assessment of tumor size and surgical planning in early BC. METHODS: We performed a retrospective review of a prospectively collected database of 174 patients treated at a single institution for invasive BC who had complete documentation of the tumor size from mammography (MMG), ultrasonography (US), and MRI. RESULTS: A total of 186 breast tumors were analyzed. Mean tumor size varied by imaging method: 14.7 mm by MMG, 13.8 mm by US, and 17.9 mm by MRI. The concordance between breast imaging techniques (BIT) and final pathology with a cutoff ≤ 2 mm was 34.8% for MRI, 32.1% for US, and 27.2% for MMG. US and MMG underestimated while MRI and MMG overestimated the real tumor size. Concordance was the same in premenopausal women for MRI and US at 35%, while concordance was higher in postmenopausal women for MRI. Correlations between size determined by BIT and histopathological size were best with MRI (0.59), compared to US (0.56) or MMG (0.42). Intrinsic subtypes of BC had different concordances according to imaging method, but no significant associations were found. MRI examination revealed additional lesions in 13.8% of patients, 69% of these lesions were malignant. MRI changed the surgical plan in 15 patients (8.6%), and the rate of mastectomy increased by 6.9%. CONCLUSIONS: MRI estimates BC tumor size more accurately than US or MMG, but a significant overestimation exists. Complementary MRI examination improved the concordance for tumor size between BIT and final pathology in 16.7%. MRI did not alter surgical planning for most patients and allowed more appropriate treatment for 8% of them.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès interdit
Publication date 2018
Language Anglais
Journal information "The breast journal" - Vol. 24, no. 6, p. 927-933 (2018)
Peer reviewed yes
Publisher Blackwell Science ((United States) Malden, MA)
issn 1075-122X
e-issn 1524-4741
Publication status Publié
Affiliations UCL - (MGD) Service d'anatomie pathologique
UCL - SSS/IREC/MONT - Pôle Mont Godinne
Keywords MRI ; breast cancer ; pathology ; surgical treatment ; tumor size
Links
  1. Kaplan Henry G., Malmgren Judith A., Atwood Mary K., Calip Gregory S., Effect of treatment and mammography detection on breast cancer survival over time: 1990-2007 : Improved Breast Ca Survival Over Time, 10.1002/cncr.29371
  2. Saadatmand Sepideh, Bretveld Reini, Siesling Sabine, Tilanus-Linthorst Madeleine M A, Influence of tumour stage at breast cancer detection on survival in modern times: population based study in 173 797 patients, 10.1136/bmj.h4901
  3. Colzani Edoardo, Liljegren Annelie, Johansson Anna L.V., Adolfsson Jan, Hellborg Henrik, Hall Per F.L., Czene Kamila, Prognosis of Patients With Breast Cancer: Causes of Death and Effects of Time Since Diagnosis, Age, and Tumor Characteristics, 10.1200/jco.2010.32.6462
  4. Miller Marian, Ottesen Rebecca A., Niland Joyce C., Kruper Laura, Chen Steven L., Vito Courtney, Tumor Response Ratio Predicts Overall Survival in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy, 10.1245/s10434-014-3922-0
  5. Ataseven Beyhan, Lederer Bianca, Blohmer Jens U., Denkert Carsten, Gerber Bernd, Heil Jörg, Kühn Thorsten, Kümmel Sherko, Rezai Mahdi, Loibl Sibylle, von Minckwitz Gunter, Impact of Multifocal or Multicentric Disease on Surgery and Locoregional, Distant and Overall Survival of 6,134 Breast Cancer Patients Treated With Neoadjuvant Chemotherapy, 10.1245/s10434-014-4122-7
  6. Smith Benjamin D., Arthur Douglas W., Buchholz Thomas A., Haffty Bruce G., Hahn Carol A., Hardenbergh Patricia H., Julian Thomas B., Marks Lawrence B., Todor Dorin A., Vicini Frank A., Whelan Timothy J., White Julia, Wo Jennifer Y., Harris Jay R., Accelerated Partial Breast Irradiation Consensus Statement From the American Society for Radiation Oncology (ASTRO), 10.1016/j.ijrobp.2009.02.031
  7. Pilewskie Melissa, King Tari A., Magnetic resonance imaging in patients with newly diagnosed breast cancer: A review of the literature : MRI and Newly Diagnosed Breast Cancer, 10.1002/cncr.28700
  8. Plana María Nieves, Carreira Carmen, Muriel Alfonso, Chiva Miguel, Abraira Víctor, Emparanza Jose Ignacio, Bonfill Xavier, Zamora Javier, Magnetic resonance imaging in the preoperative assessment of patients with primary breast cancer: systematic review of diagnostic accuracy and meta-analysis, 10.1007/s00330-011-2238-8
  9. Bae Min Sun, Lee Su Hyun, Chu A Jung, Shin Sung Ui, Ryu Han Suk, Moon Woo Kyung, Preoperative MR Imaging in Women with Breast Cancer Detected at Screening US, 10.1148/radiol.2016160706
  10. Houssami Nehmat, Turner Robin, Morrow Monica, Preoperative Magnetic Resonance Imaging in Breast Cancer : Meta-Analysis of Surgical Outcomes, 10.1097/sla.0b013e31827a8d17
  11. Senkus E., Kyriakides S., Penault-Llorca F., Poortmans P., Thompson A., Zackrisson S., Cardoso F., , Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up, 10.1093/annonc/mdt284
  12. Philippson C., Simon S., Vandekerkhove C., Hertens D., Veys I., Noterman D., De Neubourg F., Larsimont D., Bourgeois P., Van Houtte P., Nogaret J. M., Early Invasive Cancer and Partial Intraoperative Electron Radiation Therapy of the Breast: Experience of the Jules Bordet Institute, 10.1155/2014/627352
  13. Kolb Thomas M., Lichy Jacob, Newhouse Jeffrey H., Comparison of the Performance of Screening Mammography, Physical Examination, and Breast US and Evaluation of Factors that Influence Them: An Analysis of 27,825 Patient Evaluations, 10.1148/radiol.2251011667
  14. Kerlikowske Karla, Cook Andrea J., Buist Diana S.M., Cummings Steve R., Vachon Celine, Vacek Pamela, Miglioretti Diana L., Breast Cancer Risk by Breast Density, Menopause, and Postmenopausal Hormone Therapy Use, 10.1200/jco.2009.26.4770
  15. Grimsby Gwen M., Gray Richard, Dueck Amylou, Carpenter Susanne, Stucky Chee-Chee, Aspey Heidi, Giurescu Marina E., Pockaj Barbara, Is there concordance of invasive breast cancer pathologic tumor size with magnetic resonance imaging?, 10.1016/j.amjsurg.2009.07.012
  16. Onesti Jill K., Mangus Barry E., Helmer Stephen D., Osland Jacqueline S., Breast cancer tumor size: correlation between magnetic resonance imaging and pathology measurements, 10.1016/j.amjsurg.2008.07.028
  17. Turnbull Lindsay, Brown Sarah, Harvey Ian, Olivier Catherine, Drew Phil, Napp Vicky, Hanby Andrew, Brown Julia, Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial, 10.1016/s0140-6736(09)62070-5
  18. Peters N.H.G.M., van Esser S., van den Bosch M.A.A.J., Storm R.K., Plaisier P.W., van Dalen T., Diepstraten S.C.E., Weits T., Westenend P.J., Stapper G., Fernandez-Gallardo M.A., Borel Rinkes I.H.M., van Hillegersberg R., Mali W.P.Th.M., Peeters P.H.M., Preoperative MRI and surgical management in patients with nonpalpable breast cancer: The MONET – Randomised controlled trial, 10.1016/j.ejca.2010.11.035
  19. Leddy Rebecca, Irshad Abid, Metcalfe Allie, Mabalam Pramod, Abid Ahad, Ackerman Susan, Lewis Madelene, Comparative accuracy of preoperative tumor size assessment on mammography, sonography, and MRI: Is the accuracy affected by breast density or cancer subtype? : Accuracy of Tumor Size on MM, US, and MRI, 10.1002/jcu.22290
  20. Fancellu Alessandro, Soro Daniela, Castiglia Paolo, Marras Vincenzo, Melis Marcovalerio, Cottu Pietrina, Cherchi Alessandra, Spanu Angela, Mulas Silvia, Pusceddu Claudio, Simbula Luca, Meloni Giovanni B., Usefulness of Magnetic Resonance in Patients With Invasive Cancer Eligible for Breast Conservation: A Comparative Study, 10.1016/j.clbc.2013.10.002
  21. Barco Israel, Chabrera Carolina, García-Fernández Antonio, Fraile Manel, Vidal MCarmen, González Sonia, Lain Jose María, Reñé Assumpta, Canales Lidia, Vallejo Elena, Deu Jordi, Pessarrodona Antoni, Giménez Nuria, García-Font Marc, Magnetic resonance imaging in the preoperative setting for breast cancer patients with undetected additional disease, 10.1016/j.ejrad.2016.07.020
  22. King Valencia, Gu Yajia, Kaplan Jennifer B., Brooks Jennifer D., Pike Malcolm C., Morris Elizabeth A, Impact of menopausal status on background parenchymal enhancement and fibroglandular tissue on breast MRI, 10.1007/s00330-012-2553-8
  23. Dontchos Brian N., Rahbar Habib, Partridge Savannah C., Korde Larissa A., Lam Diana L., Scheel John R., Peacock Sue, Lehman Constance D., Are Qualitative Assessments of Background Parenchymal Enhancement, Amount of Fibroglandular Tissue on MR Images, and Mammographic Density Associated with Breast Cancer Risk?, 10.1148/radiol.2015142304
  24. Drisis Stylianos, Metens Thierry, Ignatiadis Michael, Stathopoulos Konstantinos, Chao Shih-Li, Lemort Marc, Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy, 10.1007/s00330-015-3948-0
  25. Grimm Lars J., Johnson Karen S., Marcom P. Kelly, Baker Jay A., Soo Mary S., Can Breast Cancer Molecular Subtype Help to Select Patients for Preoperative MR Imaging?, 10.1148/radiol.14140594
  26. Gonzalez Virginia, Sandelin Kerstin, Karlsson Anders, Åberg Wiveca, Löfgren Lars, Iliescu Gabriela, Eriksson Staffan, Arver Brita, Preoperative MRI of the Breast (POMB) Influences Primary Treatment in Breast Cancer: A Prospective, Randomized, Multicenter Study, 10.1007/s00268-014-2605-0
  27. Moon H. G., Han W., Kim J. Y., Kim S. J., Yoon J. H., Oh S. J., Yu J. H., Noh D. Y., Effect of multiple invasive foci on breast cancer outcomes according to the molecular subtypes: a report from the Korean Breast Cancer Society, 10.1093/annonc/mdt187
  28. Weissenbacher Tobias M., Zschage Madeleine, Janni Wolfgang, Jeschke Udo, Dimpfl Thomas, Mayr Doris, Rack Brigitte, Schindlbeck Christian, Friese Klaus, Dian Darius, Multicentric and multifocal versus unifocal breast cancer: is the tumor-node-metastasis classification justified?, 10.1007/s10549-010-0917-9
  29. Di Leo Giovanni, Trimboli Rubina Manuela, Benedek Adrienn, Jereczek-Fossa Barbara Alicja, Fossati Piero, Leonardi Maria Cristina, Carbonaro Luca Alessandro, Orecchia Roberto, Sardanelli Francesco, MR Imaging for Selection of Patients for Partial Breast Irradiation: A Systematic Review and Meta-Analysis, 10.1148/radiol.2015142508
Bibliographic reference Pop, Catalin-Florin ; Stanciu-Pop, Claudia ; Drisis, Stylianos ; Radermeker, Magali ; Vandemerckt, Carine ; et. al. The impact of breast MRI workup on tumor size assessment and surgical planning in patients with early breast cancer.. In: The breast journal, Vol. 24, no. 6, p. 927-933 (2018)
Permanent URL http://hdl.handle.net/2078.1/201806