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Contrast-enhanced MRI in breast cancer patients eligible for breast-conserving therapy: complementary value for subgroups of patients

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Abstract

The aim of this study was to identify patients prior to breast-conserving therapy (BCT) who have complementary value of contrast-enhanced magnetic resonance imaging (MRI) over conventional imaging in the assessment of tumor extent. All patients were eligible for BCT according to conventional imaging, and underwent preoperative MRI as part of this study. One hundred and sixty-five patients (166 tumors) were included. MRI was defined to have complementary value if conventional imaging underestimated or overestimated tumor extent (by more than 10 mm compared to histology) and MRI assessed the extent accurately. Logistic regression was employed to identify characteristics that are predictive of the complementary value of preoperative MRI. MRI had complementary value in 39 cases (23%). Patients <58 years old with irregular lesion margins at mammography and discrepancy in tumor extent by more than 10 mm between mammography and ultrasonography had a 3.2× higher chance of accurate assessment at MRI (positive predictive value 50%, negative predictive value 84%, p=0.0002). Preoperative MRI in patients eligible for BCT is more accurate than conventional imaging in the assessment of tumor extent in approximately one out of four patients. Subgroups of patients in whom MRI has complementary value may be defined by the differences in clinical and imaging features.

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Abbreviations

MRI:

Magnetic resonance imaging

BCT:

Breast-conserving therapy

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Acknowledgements

This work was financially supported by the Dutch Cancer Society, grant no. NKI 99–2035. The authors thank Guus Hart MSc for proofing the statistical techniques.

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Authors and Affiliations

  1. Department of Radiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Eline E. Deurloo, William F. A. Klein Zeggelink, H. Jelle Teertstra, Sara H. Muller & Kenneth G. A. Gilhuijs

  2. Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Eline E. Deurloo

  3. Department of Pathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Johannes L. Peterse

  4. Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Emiel J. Th. Rutgers

  5. Department of Radiotherapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Harry Bartelink

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  1. Eline E. Deurloo
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  2. William F. A. Klein Zeggelink
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Correspondence to Kenneth G. A. Gilhuijs.

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Deurloo, E.E., Klein Zeggelink, W.F.A., Teertstra, H.J. et al. Contrast-enhanced MRI in breast cancer patients eligible for breast-conserving therapy: complementary value for subgroups of patients. Eur Radiol 16, 692–701 (2006). https://doi.org/10.1007/s00330-005-0043-y

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