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Importance of Presurgical Breast MRI in Patients 60 Years of Age and Older

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Specialty Radiology
Date 2014 Sep 25
PMID 25250195
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Abstract

Objective: To demonstrate the importance of presurgical bilateral breast Magnetic Resonance Imaging (MRI) in women 60 years of age and older.

Materials And Methods: Institutional review board approval was obtained with waiver of informed consent for this retrospective review. From December 2003 to December 2011, all patients 60 years and older who had presurgical bilateral breast MRI were reviewed, revealing 1268 presurgical MRI examinations; 310 had a new lesion identified by MRI. Cases were excluded due to incomplete or missing data, resulting in 243 patients with 272 findings eligible for analysis. Data recorded included patient demographics, core biopsy method and pathology, type of surgery, and surgical pathology results.

Results: Of 1268 exams performed in this population, 272 (21.5%) patients with suspicious MRI findings underwent needle biopsy. Malignancy was found in 114 (42%), benign findings in 127 (47%), and atypia in 31 (11%). Of the malignancies, 83 were in the ipsilateral breast and 31 in the contralateral breast to the original diagnosis. Of the ipsilateral findings, 47 were in the same quadrant as the primary diagnosis, 28 in a different quadrant, and 8 were metastatic lymph nodes. Of the 31 atypical findings, 14 were contralateral to the primary diagnosis and 17 were ipsilateral. Two hundred and thirty-three patients underwent surgical excision; 111 changed their surgical management as a lesion was seen on MRI and was diagnosed as cancer on needle biopsy.

Conclusions: Among the patients aged 60 years and above who had presurgical bilateral breast MRI, we found additional cancers in 9.0% (n = 114/1268) and atypia in 2.4% (n = 31/1268). A change in management as a result of the MRI-detected lesion occurred in 8.8% (n = 111/1268). These results demonstrate that performing presurgical bilateral breast MRI is of value in women 60 years of age and above.

References
1.
Liberman L, Morris E, Dershaw D, Abramson A, Tan L . MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol. 2003; 180(4):901-10. DOI: 10.2214/ajr.180.4.1800901. View

2.
Fortune-Greeley A, Wheeler S, Meyer A, Reeder-Hayes K, Biddle A, Muss H . Preoperative breast MRI and surgical outcomes in elderly women with invasive ductal and lobular carcinoma: a population-based study. Breast Cancer Res Treat. 2013; 143(1):203-12. PMC: 4093828. DOI: 10.1007/s10549-013-2787-4. View

3.
Solin L, Orel S, Hwang W, Harris E, Schnall M . Relationship of breast magnetic resonance imaging to outcome after breast-conservation treatment with radiation for women with early-stage invasive breast carcinoma or ductal carcinoma in situ. J Clin Oncol. 2008; 26(3):386-91. DOI: 10.1200/JCO.2006.09.5448. View

4.
Bedrosian I, Mick R, Orel S, Schnall M, Reynolds C, Spitz F . Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer. 2003; 98(3):468-73. DOI: 10.1002/cncr.11490. View

5.
Deurloo E, Peterse J, Rutgers E, Besnard A, Muller S, Gilhuijs K . Additional breast lesions in patients eligible for breast-conserving therapy by MRI: impact on preoperative management and potential benefit of computerised analysis. Eur J Cancer. 2005; 41(10):1393-401. DOI: 10.1016/j.ejca.2005.03.017. View