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Comparative Study
. 2006;8(5):R53.
doi: 10.1186/bcr1600.

Magnetic resonance mammography in the evaluation of recurrence at the prior lumpectomy site after conservative surgery and radiotherapy

Lorenzo Preda  1 , Gaetano Villa, Stefania Rizzo, Luca Bazzi, Daniela Origgi, Enrico Cassano, Massimo Bellomi
Affiliations
Comparative Study

Magnetic resonance mammography in the evaluation of recurrence at the prior lumpectomy site after conservative surgery and radiotherapy

Lorenzo Preda et al. Breast Cancer Res. 2006.

Abstract

Introduction: The aim was to assess the value of magnetic resonance mammography (MRM) in the detection of recurrent breast cancer on the prior lumpectomy site in patients with previous conservative surgery and radiotherapy.

Methods: Between April 1999 and July 2003, 93 consecutive patients with breast cancer treated with conservative surgery and radiotherapy underwent MRM, when a malignant lesion on the site of lumpectomy was suspected by ultrasound and/or mammography. MRM scans were evaluated by morphological and dynamic characteristics. MRM diagnosis was compared with histology or with a 36-month imaging follow-up. Enhancing areas independent of the prior lumpectomy site, incidentally detected during the MRM, were also evaluated.

Results: MRM findings were compared with histology in 29 patients and with a 36-month follow-up in 64 patients. MRM showed 90% sensitivity, 91.6% specificity, 56.3% positive predictive value and 98.7% negative predictive value for detection of recurrence on the surgical scar. MRM detected 13 lesions remote from the scar. The overall sensitivity, specificity, positive predictive value and negative predictive value of MRM for detection of breast malignancy were 93.8%, 90%, 62.5% and 98.8%, respectively.

Conclusion: MRM is a sensitive method to differentiate recurrence from post-treatment changes at the prior lumpectomy site after conservative surgery and radiation therapy. The high negative predictive value of this technique can avoid unnecessary biopsies or surgical treatments.

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Figures

Figure 1
Figure 1
Magnetic resonance mammography 4 years after treatment for invasive ductal carcinoma. This shows a 2 cm lesion (left image), with a signal–intensity curve with early wash-in and late washout (right image) (Breast Imaging Reporting and Data System V) (invasive ductal carcinoma at histology).
Figure 2
Figure 2
Magnetic resonance mammography 15 months after surgery. The postcontrast image (left image) and the signal–intensity curve (right image) show a 2 cm lesion with inhomogeneous enhancement. (Breast Imaging Reporting and Data System IV). Histology and follow-up reported no malignancy.
Figure 3
Figure 3
Magnetic resonance mammography of 52-year-old patient who underwent quadrantectomy, adenectomy and radiotherapy for mucinous cancer. This shows a 3 cm rounded lesion with homogeneous contrast enhancement (left image), with the signal–intensity curve showing moderate initial increase and late steady increase (right image). The lesion (Breast Imaging Reporting and Data System II) was mucinous cancer.
Figure 4
Figure 4
Magnetic resonance mammography 2 years after therapies for invasive ductal carcinoma. This shows two lesions (arrows) (Breast Imaging Reporting and Data System IV, V), reported by biopsy as malignant.
See this image and copyright information in PMC

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