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10.1245/ASO.2004.12.008
Annals of Surgical Oncology 11:756-761 (2004)
© 2004 Society of Surgical Oncology
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ORIGINAL ARTICLES

Preoperative Magnetic Resonance Imaging Evaluation for Breast Cancers After Sonographically Guided Core-Needle Biopsy: A Comparison Study

Yun-Chung Cheung, MD, Yung-Liang Wan, MD, Yung-Feng Lo, MD, Wai-Man Leung, MD, Shin-Cheh Chen, MD and Swei Hsueh, MD

From the Department of Diagnostic Radiology (Y-CC, Y-LW), Chang Gung Memorial Hospital, College of Medicine, and School of Medical Technology; and Departments of Surgery (Y-FL, S-CC), Radiation Oncology (W-ML), and Pathology (SH), Chang Gung Memorial Hospital, Kwei Shan, Tao Yuan Hsien, Taiwan.

Correspondence: Address correspondence and reprint requests to: Shin-Cheh Chen, MD, Department of Surgery, Chang Gung Memorial Hospital, 5 Fu Hsing Road, Kwei Shan, Tao Yuan Hsien, Taiwan; Fax: 886-3-3330365; E-mail: alex2143{at}ms33.hinet.net

Background: The aim of the study was to evaluate the efficacy of contrast-enhanced magnetic resonance imaging (MRI) for preoperative assessment of palpable breast cancer after sonographically guided percutaneous core-needle biopsy.

Methods: Thirty-six breast cancers in 35 women that had been diagnosed by sonographically guided core-needle biopsy prior to subsequent MRI were evaluated in this retrospective study. Radiological and pathological reports, multiplicity, retroareolar involvement, and the size of the breast cancers were reviewed. The cancer sizes, as derived from sonography and enhanced MRI, were correlated with histological size in greatest diameter by means of Pearson’s correlation. The threshold value for significance was set at P < .05.

Results: Synchronous breast cancers were revealed in the index cases by means of enhanced MRI (10), sonography (8), and mammography (7). Two of the 36 index cancers (5.6%) benefited from MRI assessment. Retroareolar cancer extension was observed with enhanced MRI in five index cancers. Of these, one was also noted on both a sonogram and a mammogram. Four of the index cancers (11.1%) benefited from the enhanced MRI. Overall, five index cancers (13.9%) benefited from the enhanced MRI. With a gold standard of histology, the mean cancer sizes were underestimated by sonography and overestimated by enhanced MRI. In comparison with sonography, a stronger association was noted between MRI and histological measurements, with coefficients of 0.657 and 0.882, respectively (P < .001).

Conclusions: In a clinical setting, MRI for preoperative assessment of breast cancers is warranted. Minimally invasive, percutaneous core-needle biopsy did not alter the clinical efficacy of the MRI evaluation.

Key Words: Breast cancer • Conservative mastectomy • Magnetic resonance imaging • Needle biopsy • Preoperative planning • Sonography






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