| Abstract: |
Planning appropriate surgical treatment for women who have breast cancer requires accurate assessment of extent of disease. MR imaging can depict breast cancer that is not palpable and not evident at mammography or ultrasonography. Among women with breast cancer who had breast MR imaging for assessment of extent of disease in published studies, MR imaging depicted an otherwise unsuspected cancer in the ipsilateral breast in 16% (range, 6%-34%) and in the contralateral breast in 6% (range, 3%-24%). MR imaging is most likely to identify additional sites of disease in the ipsilateral and contralateral breast in women with invasive lobular histology in the index cancer and a family history of breast cancer. MR imaging can also assist in the evaluating involvement of the skin, pectoral muscle, and chest wall. Although published data indicate that breast MR imaging can depict additional sites of cancer in women with breast cancer, further investigation is necessary. In which subgroups of women, based on patient, breast, or lesion factors, is MR imaging most likely to identify additional sites of cancer? Does identification of these additional sites improve disease-free or overall survival? A randomized, controlled trial would provide information, but the need for and logistics of such a study remain a matter of debate. Potential disadvantages of MR imaging include cost and additional procedures, such as follow-up and biopsy. Furthermore, for breast MR imaging to be useful in assessing extent of disease, it is necessary to have the capability to perform biopsy of lesions identified only by MR imaging. Additional work, including refinement of criteria and methods for performing biopsy of MR imaging-detected lesions and long-term follow-up evaluation, is essential to optimize the use of breast MR imaging in assessing the extent of disease. © 2006 Elsevier Inc. All rights reserved. |
