Monitoring of Breast Lesions after Breast Conservative Therapy: Does A Combination of Dynamic and Functional MRI Techniques Can Add Value in Early Detection of Recurrent Malignancy?
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- Category: Vol. 87, December 2019
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Monitoring of Breast Lesions after Breast Conservative Therapy: Does A Combination of Dynamic and Functional MRI Techniques Can Add Value in Early Detection of Recurrent Malignancy?, MOHAMAD F. SHERIF, NAGLA L. DABEES, SAMAR G. YONES and OM YOSEF A. KHEDR
Abstract
Background: To assess efficacy of combined dynamic and functional MRI techniques in early detection of recurrent malignancy after breast conservative therapy and differentiating it from other post-operative lesions.
Aim of Study: To assess efficacy of combined dynamic and functional MRI techniques in early detection of recurrent malignancy after breast conservative therapy and differentiating it from other post-operative lesions.
Patients and Methods: Thirty female patients who under-went breast conservative therapy were involved in this pro-spective study. Patients were examined by sono-mammography that aroused suspicious of breast lesions followed by DCE-MRI & DWI-MRI to exclude recurrence. DWI was performed using b-values of 50, 400, 800s/mm2. All patients were subjected to histopathological confirmation which was the gold standard in this study.
Results: Eight patients had pathologically proven recur-rence and 22 patients showed spectrum of post-operative changes. DCE- MRI diagnosis (considering lesion morphology, enhancement pattern) overestimated 2 lesions were scored BIRADS 4 and proved pathologically as fat necrosis.
When adding the data elicited by the DWI to the DCE-MRI assessment, the statistical analysis presented 100% sensitivity, 95.4% specificity, 88.9% PPV, 100% NPV and 96.6% accuracy.
Conclusion: Combination of functional & dynamic MRI techniques added high significant value in follow-up of breast lesion occurred after BCT as it can avoid biopsy in positive patients, to send negative patients to follow-up and reserving biopsy in the cases with a clinico-radiological mismatch. Breast MRI should be the imaging modality of choice in detection of the tumoral recurrence, and differentiating it from other post-operative lesions.