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Review
. 2008 Jan;107(1):1-14.
doi: 10.1007/s10549-007-9528-5. Epub 2007 Feb 15.

MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature

Ritse M Mann  1 , Yvonne L Hoogeveen, Johan G Blickman, Carla Boetes
Affiliations
Review

MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature

Ritse M Mann et al. Breast Cancer Res Treat. 2008 Jan.

Abstract

Purpose: The clinical diagnosis and management of invasive lobular carcinoma (ILC) of the breast presents difficulties. Magnetic resonance imaging (MRI) has been proposed as the imaging modality of choice for the evaluation of ILC. Small studies addressing different aspects of MRI in ILC have been presented but no large series to date. To address the usefulness of MRI in the work-up of ILC, we performed a review of the currently published literature.

Materials and methods: We performed a literature search using the query "lobular AND (MRI OR MR OR MRT OR magnetic)" in the Cochrane library, PubMed and scholar.google.com, to retrieve all articles that dealt with the use of MRI in patients with ILC. We addressed sensitivity, morphologic appearance, correlation with pathology, detection of additional lesions, and impact of MRI on surgery as different endpoints. Whenever possible we performed meta-analysis of the pooled data.

Results: Sensitivity is 93.3% and equal to overall sensitivity of MRI for malignancy in the breast. Morphologic appearance is highly heterogeneous and probably heavily influenced by interreader variability. Correlation with pathology ranges from 0.81 to 0.97; overestimation of lesion size occurs but is rare. In 32% of patients, additional ipsilateral lesions are detected and in 7% contralateral lesions are only detected by MRI. Consequently, MRI induces change in surgical management in 28.3% of cases.

Conclusion: This analysis indicates MRI to be valuable in the work-up of ILC. It provides additional knowledge that cannot be obtained by conventional imaging modalities which can be helpful in patient treatment.

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Figures

Fig. 1
Fig. 1
Forestplot of the sensitivity of the respective modalities for ILC (MMG mammography, US ultrasound, CE clinical examination), the horizontal lines represent 95% confidence intervals. Modalities presented on the right of the authors name have not been tested in the appropriate study. The diamonds at the bottom represent the pooled estimates and their 95% confidence intervals for MRI and US, respectively. Because mammography and clinical examination were too heterogeneous for meta-analysis no pooled estimate is presented for these modalities
See this image and copyright information in PMC

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