Breast carcinoma: MR imaging before re-excisional biopsy

Area of Science:

• Radiology
• Oncology
• Breast Imaging

Background:

• Excisional biopsy is a common procedure for breast carcinoma.
• Accurate assessment of residual disease post-biopsy is crucial for treatment planning.
• Limitations exist in conventional imaging modalities for detecting residual tumor extent.

Purpose of the Study:

• To evaluate the diagnostic performance of magnetic resonance (MR) imaging.
• To assess MR imaging's role in identifying residual breast carcinoma after excisional biopsy.
• To determine if MR imaging can guide decisions before re-excision surgery.

Main Methods:

• Contrast-enhanced MR imaging was performed on 47 patients.
• Patients underwent MR imaging after initial excisional biopsy and before further surgery.
• Data analyzed for positive and negative predictive values of MR imaging.

Main Results:

• MR imaging demonstrated an 82% positive predictive value for residual disease.
• Sixteen percent of patients (14/47) had multifocal or diffuse residual carcinoma.
• In 4 patients, MR imaging findings led to a change in management, including mastectomy.

Conclusions:

• MR imaging is valuable for detecting residual breast cancer after excisional biopsy.
• It can identify unsuspected multifocal or extensive disease, supporting mastectomy over re-excision.
• Postsurgical changes and enhancement of benign tissue are limitations to consider.