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Japanese Journal of Clinical Oncology 2004 34(9):515-518; doi:10.1093/jjco/hyh094
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© 2004 Foundation for Promotion of Cancer Research

Comparison of Intraductal Spread on Dynamic Contrast-enhanced MRI with Clinicopathologic Features in Breast Cancer

Shuhei Komatsu1,4, Chol Joo Lee1, Yohei Hosokawa2, Daisuke Ichikawa1,4, Takashi Hamashima1, Koichi Shirono1, Harumi Okabe3, Hideaki Kurioka1 and Takahiro Oka1

1 Department of Surgery, 2 Department of Pathology and 3 Department of Radiology, Kyoto First Red Cross Hospital, Kyoto and 4 Department of Digestive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

For reprints and all correspondence: Shuhei Komatsu, Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachihirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. E-mail: syuhei{at}mx.biwa.ne.jp

Received February 9, 2004; accepted June 13, 2004

Objective: Contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a new diagnostic technology in various breast cancer treatments. However, little is known about the correlation between intraductal spread on CE-MRI and clinicopathologic features. This study was designed to evaluate these correlations for the surgical planning of breast cancer.

Methods: Twenty-six breast cancer lesions (in 26 female patients) treated by breast conserving surgery between March 2001 and March 2003 were evaluated retrospectively. CE-MRI was performed with a 1.5 T unit using a dedicated bilateral breast coil.

Results: In detecting intraductal spread of breast cancer, the sensitivity, specificity and accuracy of CE-MRI were 82.4%, 60.0% and 77.3%, respectively. On mammography (MMG), these were 21.1%, 100.0% and 42.3%, respectively. Therefore, CE-MRI has a higher sensitivity and accuracy, although with a lower specificity than MMG. Compared with breast cancer lesions without intraductal spread on CE-MRI, lesions with intraductal spread on CE-MRI were found more frequently in larger-sized tumors (P = 0.0088).

Conclusion: Preoperative evaluation for intraductal spread by CE-MRI should be more useful than by MMG for breast cancer. When making the surgical decision regarding excision range, particular attention should be paid to this consideration for patients with larger-sized cancer tumors.

Key Words: breast cancer • breast conserving surgery • contrast-enhanced MRI • intraductal spread • MRI


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