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McDonald ES, Scheel JR, Lewin AA, Weinstein SP, Dodelzon K, Dogan BE, Fitzpatrick A, Kuzmiak CM, Newell MS, Paulis LV, Pilewskie M, Salkowski LR, Silva HC, Sharpe RE, Specht JM, Ulaner GA, Slanetz PJ. ACR Appropriateness Criteria® Imaging of Invasive Breast Cancer. J Am Coll Radiol 2024; 21:S168-S202. [PMID: 38823943 DOI: 10.1016/j.jacr.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 06/03/2024]
Abstract
As the proportion of women diagnosed with invasive breast cancer increases, the role of imaging for staging and surveillance purposes should be determined based on evidence-based guidelines. It is important to understand the indications for extent of disease evaluation and staging, as unnecessary imaging can delay care and even result in adverse outcomes. In asymptomatic patients that received treatment for curative intent, there is no role for imaging to screen for distant recurrence. Routine surveillance with an annual 2-D mammogram and/or tomosynthesis is recommended to detect an in-breast recurrence or a new primary breast cancer in women with a history of breast cancer, and MRI is increasingly used as an additional screening tool in this population, especially in women with dense breasts. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
- Elizabeth S McDonald
- Research Author, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - John R Scheel
- Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Alana A Lewin
- Panel Chair, New York University Grossman School of Medicine, New York, New York
| | - Susan P Weinstein
- Panel Vice Chair, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Basak E Dogan
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Amy Fitzpatrick
- Boston Medical Center, Boston, Massachusetts, Primary care physician
| | | | - Mary S Newell
- Emory University Hospital, Atlanta, Georgia; RADS Committee
| | | | - Melissa Pilewskie
- University of Michigan, Ann Arbor, Michigan; Society of Surgical Oncology
| | - Lonie R Salkowski
- University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin
| | - H Colleen Silva
- The University of Texas Medical Branch, Galveston, Texas; American College of Surgeons
| | | | - Jennifer M Specht
- University of Washington, Seattle, Washington; American Society of Clinical Oncology
| | - Gary A Ulaner
- Hoag Family Cancer Institute, Newport Beach, California; University of Southern California, Los Angeles, California; Commission on Nuclear Medicine and Molecular Imaging
| | - Priscilla J Slanetz
- Specialty Chair, Boston University School of Medicine, Boston, Massachusetts
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2
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Pereslucha AM, Wenger DM, Morris MF, Aydi ZB. Invasive Lobular Carcinoma: A Review of Imaging Modalities with Special Focus on Pathology Concordance. Healthcare (Basel) 2023; 11:healthcare11050746. [PMID: 36900751 PMCID: PMC10000992 DOI: 10.3390/healthcare11050746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Invasive lobular cancer (ILC) is the second most common type of breast cancer. It is characterized by a unique growth pattern making it difficult to detect on conventional breast imaging. ILC can be multicentric, multifocal, and bilateral, with a high likelihood of incomplete excision after breast-conserving surgery. We reviewed the conventional as well as newly emerging imaging modalities for detecting and determining the extent of ILC- and compared the main advantages of MRI vs. contrast-enhanced mammogram (CEM). Our review of the literature finds that MRI and CEM clearly surpass conventional breast imaging in terms of sensitivity, specificity, ipsilateral and contralateral cancer detection, concordance, and estimation of tumor size for ILC. Both MRI and CEM have each been shown to enhance surgical outcomes in patients with newly diagnosed ILC that had one of these imaging modalities added to their preoperative workup.
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Affiliation(s)
- Alicia M Pereslucha
- Department of Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ 85006, USA
| | - Danielle M Wenger
- College of Medicine-Phoenix, University of Arizona, Phoenix, AZ 85004, USA
| | - Michael F Morris
- Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, Phoenix, AZ 85006, USA
- Department of Radiology, Banner University Medical Center-Phoenix, Phoenix, AZ 85006, USA
| | - Zeynep Bostanci Aydi
- Department of Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ 85006, USA
- Department of Surgical Oncology, Banner MD Anderson Cancer Center, Phoenix, AZ 85006, USA
- Correspondence:
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3
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Hovis KK, Lee JM, Hippe DS, Linden H, Flanagan MR, Kilgore MR, Yee J, Partridge SC, Rahbar H. Accuracy of Preoperative Breast MRI Versus Conventional Imaging in Measuring Pathologic Extent of Invasive Lobular Carcinoma. JOURNAL OF BREAST IMAGING 2021; 3:288-298. [PMID: 34061121 PMCID: PMC8139612 DOI: 10.1093/jbi/wbab015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine whether invasive lobular carcinoma (ILC) extent is more accurately depicted with preoperative MRI (pMRI) than conventional imaging (mammography and/or ultrasound). METHODS After IRB approval, we retrospectively identified women with pMRIs (February 2005 to January 2014) to evaluate pure ILC excluding those with ipsilateral pMRI BI-RADS 4 or 5 findings or who had neoadjuvant chemotherapy. Agreement between imaging and pathology sizes was summarized using Bland-Altman plots, absolute and percent differences, and the intraclass correlation coefficient (ICC). Rates of underestimation and overestimation were evaluated and their associations with clinical features were explored. RESULTS Among the 56 women included, pMRI demonstrated better agreement with pathology than conventional imaging by mean absolute difference (1.6 mm versus -7.8 mm, P < 0.001), percent difference (10.3% versus -16.4%, P < 0.001), and ICC (0.88 versus 0.61, P = 0.019). Conventional imaging more frequently underestimated ILC span than pMRI using a 5 mm difference threshold (24/56 (43%) versus 10/56 (18%), P < 0.001), a 25% threshold (19/53 (36%) versus 10/53 (19%), P = 0.035), and T category change (17/56 (30%) versus 7/56 (13%), P = 0.006). Imaging-pathology size concordance was greater for MRI-described solitary masses than other lesions for both MRI and conventional imaging (P < 0.05). Variability of conventional imaging was lower for patients ≥ the median age of 62 years than for younger patients (SD: 12 mm versus 22 mm, P = 0.012). CONCLUSION MRI depicts pure ILC more accurately than conventional imaging and may have particular value for younger women.
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Affiliation(s)
- Keegan K Hovis
- University of Washington School of Medicine, Department of Radiology, Seattle, WA, USA
| | - Janie M Lee
- University of Washington School of Medicine, Department of Radiology, Seattle, WA, USA
- Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Daniel S Hippe
- University of Washington School of Medicine, Department of Radiology, Seattle, WA, USA
| | - Hannah Linden
- Seattle Cancer Care Alliance, Seattle, WA, USA
- University of Washington School of Medicine, Department of Medical Oncology, Seattle, WA, USA
| | - Meghan R Flanagan
- Seattle Cancer Care Alliance, Seattle, WA, USA
- University of Washington School of Medicine, Department of Surgery, Seattle, WA, USA
| | - Mark R Kilgore
- Seattle Cancer Care Alliance, Seattle, WA, USA
- University of Washington School of Medicine, Department of Laboratory Medicine and Pathology, Seattle, WA, USA
| | - Janis Yee
- University of Washington School of Medicine, Department of Radiology, Seattle, WA, USA
| | - Savannah C Partridge
- University of Washington School of Medicine, Department of Radiology, Seattle, WA, USA
- Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Habib Rahbar
- University of Washington School of Medicine, Department of Radiology, Seattle, WA, USA
- Seattle Cancer Care Alliance, Seattle, WA, USA
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Jayaratne T, Huang YY, Jacques A, Dhillon R, Porter G, Bose S, Bourke A, Dessauvagie B, Lo G. Is staging breast magnetic resonance imaging prompted upgrade to mastectomy appropriate? ANZ J Surg 2021; 91:1772-1778. [PMID: 33908181 DOI: 10.1111/ans.16887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Breast magnetic resonance imaging (MRI) use for surgical staging is increasing, though remains controversial. We aimed to evaluate the accuracy of MRI in surgical decision-making to determine if mastectomy prompted by MRI was appropriate. METHODS A single-centre observational study in Perth, Western Australia, with the inclusion of all preoperative and postoperative studies (e.g. involved margins after breast-conserving surgery) undergoing staging breast MRI from 1 January 2015 to 26 August 2019. A standard protocol using gadolinium contrast was used. The reference standard was postoperative histopathology or, for studies without additional surgery after MRI following breast-conserving surgery, the next and subsequent annual screening episodes. By reviewing the final histopathology, the medical case notes and multidisciplinary team decision process, we evaluated whether the reported MRI disease extent was accurate in prompting an appropriate upgrade to mastectomy. Outcomes are reported with descriptive statistics. RESULTS Of 130 cancers staged with MRI; seven were excluded as information was incomplete, 104 were performed preoperatively and 19 postoperatively. The majority (60%) staged lobular carcinoma (invasive 59%, in situ 1%) compared to ductal carcinoma (invasive 31%, in situ 8%). For preoperative MRI, half (54% - 56/104) underwent subsequent mastectomy. Of these, MRI prompted mastectomy in 45% (25/56), all appropriate for disease extent. In the postoperative staging group, two mastectomies were performed, one planned before imaging, the other prompted when MRI diagnosed residual disease and confirmed on histopathology. No false-negative staging MRI was identified. CONCLUSIONS In our cohort, MRI prompted an upgrade to mastectomy in 21% (26/123), appropriate for cancer extent.
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Affiliation(s)
- Thilina Jayaratne
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Yang Yang Huang
- Department of Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Angela Jacques
- Department of Research, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Ravinder Dhillon
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,BreastScreenWA, Perth, Western Australia, Australia
| | - Gareth Porter
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,BreastScreenWA, Perth, Western Australia, Australia
| | - Sharmistha Bose
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,BreastScreenWA, Perth, Western Australia, Australia
| | - Anita Bourke
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,BreastScreenWA, Perth, Western Australia, Australia.,Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Ben Dessauvagie
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Anatomical Pathology, PathWest Laboratory Medicine WA, Perth, Western Australia, Australia.,Anatomical Pathology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Glen Lo
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,BreastScreenWA, Perth, Western Australia, Australia.,Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Medical School, Curtin University, Perth, Western Australia, Australia
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5
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Gest R, Cayet S, Arbion F, Vildé A, Body G, Ouldamer L. Predictive factors of major deviation (>20 mm) between lesion sizes measured by magnetic resonance imaging and histology for invasive lobular breast cancer. Eur J Obstet Gynecol Reprod Biol 2020; 251:14-19. [PMID: 32502770 DOI: 10.1016/j.ejogrb.2020.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To identify factors predictive of high discordance (>20 mm) between lesion sizes measured by magnetic resonance imaging (MRI) and histology for invasive lobular breast cancer. MATERIALS AND METHODS Data for all women with invasive lobular breast cancer (pure or associated with a component of invasive ductal carcinoma) between 1st January 2007 and 31st December 2016 were included in this study. Logistic regression analysis was performed to determine factors predictive of high discordance (underestimation/overestimation by >20 mm) between tumour sizes measured by MRI and histology for invasive lobular breast cancer. RESULTS For overestimation, significant factors on univariate analysis were: menopausal status [odds ratio (OR) 0.27, 95 % confidence interval (CI) 0.10-0.71]; p = 0.01], hormone receptor (HR) status (HR negative, OR 1.64, 95 % CI 0.27-9.89; HR positive, OR 0.64, 95 % CI 0.21-1.88; p = 0.09) and neoadjuvant chemotherapy (OR 10.33, 95 % CI 3.58-29.8; p < 0.001). On multivariate analysis, menopausal status and neoadjuvant chemotherapy were found to be independent predictive factors of overestimation. For underestimation, significant factors on univariate analysis were: histological size (OR 1.05, 95 % CI 1.02-1.08; p < 0.0001) and the presence of an in-situ component (OR 4.66, 95 % CI 1.01-21.5; p = 0.02). These two factors were independent predictive factors of underestimation. CONCLUSION Independent predictive factors of overestimation/underestimation (threshold 20 mm) of tumour sizes measured by MRI compared with histology for invasive lobular breast cancer were identified.
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Affiliation(s)
- Roxane Gest
- Department of Gynaecology, CHRU de Tours, Tours, France; François Rabelais University, Tours, France
| | - Sophie Cayet
- François Rabelais University, Tours, France; Department of Radiology, CHRU de Tours, Tours, France
| | - Flavie Arbion
- Department of Pathology, CHRU de Tours, Tours, France
| | - Anne Vildé
- Department of Radiology, CHRU de Tours, Tours, France
| | - Gilles Body
- Department of Gynaecology, CHRU de Tours, Tours, France; François Rabelais University, Tours, France; INSERM, Tours, France
| | - Lobna Ouldamer
- Department of Gynaecology, CHRU de Tours, Tours, France; François Rabelais University, Tours, France; INSERM, Tours, France.
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6
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Agreement between dynamic contrast-enhanced magnetic resonance imaging and pathologic tumour size of breast cancer and analysis of the correlation with BI-RADS descriptors. Pol J Radiol 2019; 84:e616-e624. [PMID: 32082460 PMCID: PMC7016361 DOI: 10.5114/pjr.2019.92285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 11/22/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose The purpose of this study was to evaluate magnetic resonance imaging (MRI)-pathology concordance of tumour size in patients with invasive breast carcinoma, with an emphasis on Breast Imaging Reporting and Data System (BI-RADS) descriptors of dynamic contrast-enhanced MRI (DCE-MRI). Material and methods Of patients who had preoperative DCE-MRI, 94 were enrolled. Concordance between MRI and the pathological findings was defined as a difference in tumour size of 5 mm or less. The greatest dimension was measured by two radiologists, and BI-RADS descriptives were described in accordance. The gold standard was chosen as the pathologic assessment. Results Tumour measurements determined by MRI and the pathological reports were not statistically different (2.64 ± 1.16 cm, Wilcaxon Z = –1.853, p = 0.064). Tumour sizes were concordant in 72/94 patients (76.6%). The mean difference between the pathological and MRI tumour sizes was –0.1 cm. MRI overestimated the size of 17/94 tumours (18.1%) and underestimated the size of 5/94 tumours (5.3%). Discordance was associated with larger tumour size. Histologic and molecular type of tumours, patient age, histologic grade, lymphovascular invasion or perineural invasion positivity, fibroglandular volume, background parenchymal enhancement, and being mass or non-mass were not associated with concordance. Irregular margin and heterogenous enhancement in DCE-MRI were associated with discordance in logistic regression analysis (p = 0.035, OR: 4.24; p = 0.021, OR: 4.96). Conclusions Two BI-RADS descriptors of irregular contour and heterogeneous contrast uptake were found to be associated with tumour size discrepancy. This might be attributed to the dynamic and morphologic specialities of tumours primarily rather than tumour biology.
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7
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[Predictive factors of concordance (5mm threshold) between MRI and histological sizes of invasive lobular breast cancer]. ACTA ACUST UNITED AC 2019; 47:291-296. [PMID: 30686731 DOI: 10.1016/j.gofs.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 12/26/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to search for predictive factors of concordance between MRI and histological sizes for invasive lobular breast cancer. MATERIAL AND METHODS All women managed for an invasive lobular breast cancer (pure or associated to a component of invasive ductal carcinoma) between 1st january 2007 and 31th december 2016 were included to the study. Univariable and multivariable analysis were performed to determine clinical or histological predictive factors of concordance between MRI and histological sizes for invasive lobular breast cancer (threshold 5mm). RESULTS During the study period 384 women were managed in our center for an invasive lobular carcinoma. We had access to the breast MRI of 246 of them. For a concordance witha threshold of 5mm, significant factors in univariate analysis were: menopausal status (OR 1.93[1.01-3.71], P=0.04), histological size (OR 0.97 [0.96-0.99], P<0.0001), lthe size of associated in situ component (OR 0.74 [0.32-1.71], P=0.01), multifocality (OR 0.56 [0.33-0.95] P=0.03) and the histological isolated invasive lobular carcinoma versus mixed ((OR 2.64 [1.01-6.91], P=0.03). In multivariate analysis, menopausal status, histological size and the histological isolated invasive lobular carcinoma versus mixed, were considered as independent predictive factors. CONCLUSION This work identified independent predictive factors of concordance between MRI and histological sizes for invasive lobular breast cancer (threshold 5mm).
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8
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Selvi V, Nori J, Meattini I, Francolini G, Morelli N, Di Benedetto D, Bicchierai G, Di Naro F, Gill MK, Orzalesi L, Sanchez L, Susini T, Bianchi S, Livi L, Miele V. Role of Magnetic Resonance Imaging in the Preoperative Staging and Work-Up of Patients Affected by Invasive Lobular Carcinoma or Invasive Ductolobular Carcinoma. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1569060. [PMID: 30046588 PMCID: PMC6038675 DOI: 10.1155/2018/1569060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 05/22/2018] [Accepted: 06/03/2018] [Indexed: 01/06/2023]
Abstract
Purpose The prevalence of invasive lobular carcinoma (ILC), the second most common type of breast cancer, accounts for 5%-15% of all invasive breast cancer cases. Its histological feature to spread in rows of single cell layers explains why it often fails to form a palpable lesion and the lack of sensitivity of mammography and ultrasound (US) to detect it. It also has a higher incidence of multifocal, multicentric, and contralateral disease when compared to the other histological subtypes. The clinicopathologic features and outcomes of Invasive Ductolobular Carcinoma (IDLC) are very similar to the ILC. The purpose of our study is to assess the importance of MRI in the preoperative management and staging of patients affected by ILC or IDLC. Materials and Methods We identified women diagnosed with ILC or IDLC. We selected the patients who had preoperative breast MRI. For each patient we identified the areas of multifocal, multicentric, or contralateral disease not visible to standard exams and detected by preoperative MRI. We analyzed the potential correlation between additional cancer areas and histological cancer markers. Results Of the 155 women who met our inclusion criteria, 93 (60%) had additional cancer areas detected by MRI. In 61 women, 39,4% of the overall population, the additional cancer areas were confirmed by US/tomosynthesis second look and biopsy. Presurgical MRI staging changed surgical management in the 37,4% of the patients. Only six patients of the overall population needed a reoperation after the initial surgery. No statistically significant correlation was found between MRI overestimation and the presence of histological peritumoral vascular/linfatic invasion. No statistically significant correlation was found between additional cancer areas and histological cancer markers. Conclusions Our study suggests that MRI is an important tool in the preoperative management and staging of patients affected by lobular or ductolobular invasive carcinoma.
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Affiliation(s)
- Valeria Selvi
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Jacopo Nori
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Icro Meattini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Giulio Francolini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Noemi Morelli
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Diego Di Benedetto
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Giulia Bicchierai
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Federica Di Naro
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | | | - Lorenzo Orzalesi
- Breast Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Luis Sanchez
- Breast Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Tommaso Susini
- Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy
| | - Simonetta Bianchi
- Division of Pathological Anatomy, University of Florence, Florence, Italy
| | - Lorenzo Livi
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
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Tseng J, Kyrillos A, Liederbach E, Spear GG, Ecanow J, Wang CH, Czechura T, Kantor O, Miller M, Winchester DJ, Pesce CE, Rabbitt S, Yao K. Clinical accuracy of preoperative breast MRI for breast cancer. J Surg Oncol 2017; 115:924-931. [PMID: 28409837 DOI: 10.1002/jso.24616] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/12/2017] [Accepted: 02/18/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND It is unclear if breast magnetic resonance imaging (MRI) is more accurate than mammography (MGM) and ultrasound (U/S) in aggregate for patients with invasive cancer. METHODS We compared concordance of combined tumor size and tumor foci between MRI and MGM and U/S combined to pathological tumor size and foci as the gold standard from 2009 to 2015. Tumor size was nonconcordant if it differed from the pathologic size by ≥33% and tumor foci was nonconcordant if >1 foci were seen. If one or both of the MGM or U/S was nonconcordant and the MRI was concordant, MRI provided greater accuracy. RESULTS Of 471 patients with MGM, US, and MRI, MRI was more accurate for 32.9% of patients for tumor size and for 21.9% for tumor foci. Patients for whom MRI had greater accuracy were compared to those who did not for clinical and tumor factors. The only significant factor was calcifications on mammography. Tumor size, stage, molecular subtype, histology, grade, patient BMI, age, mammographic density, and use of hormone replacement therapy were not significantly different. CONCLUSIONS Breast MRI provides greater accuracy for a third of patients undergoing preoperative MGM and U/S. Mammographic calcifications were associated with MRI clinical accuracy for patients with invasive cancer.
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Affiliation(s)
- Jennifer Tseng
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Alexandra Kyrillos
- Department of Surgery, NorthShore University Health System, Evanston, Illinois
| | - Erik Liederbach
- Department of Surgery, NorthShore University Health System, Evanston, Illinois
| | - Georgia G Spear
- Department of Radiology, NorthShore University Health System, Evanston, Illinois
| | - Jacob Ecanow
- Department of Radiology, NorthShore University Health System, Evanston, Illinois
| | - Chi-Hsiung Wang
- Center for Biomedical Research Informatics, NorthShore University Health System, Evanston, Illinois
| | - Tom Czechura
- Department of Surgery, NorthShore University Health System, Evanston, Illinois
| | - Olga Kantor
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Megan Miller
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - David J Winchester
- Department of Surgery, NorthShore University Health System, Evanston, Illinois
| | - Catherine E Pesce
- Department of Surgery, NorthShore University Health System, Evanston, Illinois
| | - Sarah Rabbitt
- Department of Surgery, NorthShore University Health System, Evanston, Illinois
| | - Katharine Yao
- Department of Surgery, NorthShore University Health System, Evanston, Illinois
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Corso G, Intra M, Trentin C, Veronesi P, Galimberti V. CDH1 germline mutations and hereditary lobular breast cancer. Fam Cancer 2016; 15:215-9. [PMID: 26759166 DOI: 10.1007/s10689-016-9869-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hereditary diffuse gastric cancer is an autosomal dominant inherited disease associated of CDH1 germline mutations (that encodes for the E-cadherin protein), and lobular breast cancer is the second most frequent type of neoplasia. Recently, novel E-cadherin constitutional alterations have been identified in pedigree clustering only for lobular breast carcinoma without evidence of diffuse gastric tumors and in absence of BRCA1/2 mutations. This first evidence opens novel questions about the inherited correlation between diffuse gastric and lobular breast cancers. In this brief review we revise the literature data about the CDH1 mutation frequency affecting exclusively lobular breast cancer, providing clinical recommendation for asymptomatic mutation carriers.
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Affiliation(s)
- Giovanni Corso
- Division of Senology, European Institute of Oncology, via G, Ripamonti 435, 20141, Milan, Italy.
| | - Mattia Intra
- Division of Senology, European Institute of Oncology, via G, Ripamonti 435, 20141, Milan, Italy
| | - Chiara Trentin
- Division of Breast Imaging, European Institute of Oncology, via G, Ripamonti 435, 20141, Milan, Italy
| | - Paolo Veronesi
- Division of Senology, European Institute of Oncology, via G, Ripamonti 435, 20141, Milan, Italy
| | - Viviana Galimberti
- Division of Senology, European Institute of Oncology, via G, Ripamonti 435, 20141, Milan, Italy
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Sinclair K, Sakellariou S, Dawson N, Litherland J. Does preoperative breast MRI significantly impact on initial surgical procedure and re-operation rates in patients with screen-detected invasive lobular carcinoma? Clin Radiol 2016; 71:543-50. [DOI: 10.1016/j.crad.2016.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 03/10/2016] [Accepted: 03/15/2016] [Indexed: 11/30/2022]
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12
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Parvaiz MA, Yang P, Razia E, Mascarenhas M, Deacon C, Matey P, Isgar B, Sircar T. Breast
MRI
in Invasive Lobular Carcinoma: A Useful Investigation in Surgical Planning? Breast J 2016; 22:143-50. [PMID: 26841281 DOI: 10.1111/tbj.12566] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Muhammad Asad Parvaiz
- Department of Breast & Oncoplastic Surgery Peterborough and Stamford Hospitals NHS Foundation Trust Peterborough Cambridgeshire UK
| | - Peiming Yang
- Department of Breast & Oncoplastic Surgery The Royal Wolverhampton Hospitals NHS Trust West Midlands UK
| | - Eisha Razia
- Department of Breast & Oncoplastic Surgery The Royal Wolverhampton Hospitals NHS Trust West Midlands UK
| | - Margaret Mascarenhas
- Department of Breast & Oncoplastic Surgery The Royal Wolverhampton Hospitals NHS Trust West Midlands UK
| | - Caroline Deacon
- Department of Radiology The Royal Wolverhampton Hospitals NHS Trust West Midlands UK
| | - Pilar Matey
- Department of Breast & Oncoplastic Surgery The Royal Wolverhampton Hospitals NHS Trust West Midlands UK
| | - Brian Isgar
- Department of Breast & Oncoplastic Surgery The Royal Wolverhampton Hospitals NHS Trust West Midlands UK
| | - Tapan Sircar
- Department of Breast & Oncoplastic Surgery The Royal Wolverhampton Hospitals NHS Trust West Midlands UK
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Rominger M, Berg D, Frauenfelder T, Ramaswamy A, Timmesfeld N. Which factors influence MRI-pathology concordance of tumour size measurements in breast cancer? Eur Radiol 2015; 26:1457-65. [DOI: 10.1007/s00330-015-3935-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/19/2015] [Accepted: 07/20/2015] [Indexed: 10/23/2022]
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14
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Sim YT, Vinnicombe S, Whelehan P, Thomson K, Evans A. Value of shear-wave elastography in the diagnosis of symptomatic invasive lobular breast cancer. Clin Radiol 2015; 70:604-9. [PMID: 25770021 DOI: 10.1016/j.crad.2015.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 01/28/2015] [Accepted: 02/04/2015] [Indexed: 11/18/2022]
Abstract
AIM To investigate the contribution of shear-wave elastography (SWE) in diagnosing invasive lobular breast cancer (ILC) in symptomatic patients. MATERIALS AND METHODS A retrospective case-controlled study of 52 patients with ILC and 52 patients with invasive ductal cancer (IDC), matched for age and tumour size, was performed. Breast density and mammographic and greyscale ultrasound features were graded using Breast Imaging-Reporting and Data System (BI-RADS) classification by two radiologists, blinded to SWE and pathology findings. Forty-four benign lesions were also included. The sensitivity of SWE was assessed, using a cut-off value of 50 kPa for mean elasticity. Statistical significance was evaluated using Chi-square and Chi-square for trend tests. RESULTS Mean age for both ILC and IDC groups was 67 years. Mean size for ILC was 44 mm and IDC was 37 mm. The sensitivity for detection of ILC and IDC for mammography, greyscale ultrasound, and SWE were 79% versus 87%, 87% versus 98%, 94% versus 100%, respectively. SWE had significantly higher sensitivities than mammography for the detection of both ILC and IDC (p = 0.012 and p = 0.001, respectively). SWE was not significantly more sensitive than greyscale ultrasound for the detection of either tumour type. Four (8%) lobular cancers were benign/normal at both mammography and greyscale ultrasound, but suspicious on SWE. The incremental gain in sensitivity by using SWE in ILC was statistically significant compared to IDC (p = 0.01). CONCLUSION SWE can diagnose lobular cancers that have benign/normal findings on conventional imaging as suspicious.
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Affiliation(s)
- Y T Sim
- Breast Imaging Unit, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK.
| | - S Vinnicombe
- Breast Imaging Unit, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK
| | - P Whelehan
- Breast Imaging Unit, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK
| | - K Thomson
- Breast Imaging Unit, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK
| | - A Evans
- Breast Imaging Unit, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK
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15
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Corso G, Figueiredo J, Biffi R, Trentin C, Bonanni B, Feroce I, Serrano D, Cassano E, Annibale B, Melo S, Seruca R, De Lorenzi F, Ferrara F, Piagnerelli R, Roviello F, Galimberti V. E-cadherin germline mutation carriers: clinical management and genetic implications. Cancer Metastasis Rev 2014; 33:1081-94. [PMID: 25332147 DOI: 10.1007/s10555-014-9528-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hereditary diffuse gastric cancer is an autosomic dominant syndrome associated with E-cadherin protein (CDH1) gene germline mutations. Clinical criteria for genetic screening were revised in 2010 by the International Gastric Cancer Linkage Consortium at the Cambridge meeting. About 40 % of families fulfilling clinical criteria for this inherited disease present deleterious CDH1 germline mutations. Lobular breast cancer is a neoplastic condition associated with hereditary diffuse gastric cancer syndrome. E-cadherin constitutional mutations have been described in both settings, in gastric and breast cancers. The management of CDH1 asymptomatic mutation carriers requires a multidisciplinary approach; the only life-saving procedure is the prophylactic total gastrectomy after thorough genetic counselling. Several prophylactic gastrectomies have been performed to date; conversely, no prophylactic mastectomies have been described in CDH1 mutant carriers. However, the recent discovery of novel germline alterations in pedigree clustering only for lobular breast cancer opens up a new debate in the management of these individuals. In this critical review, we describe the clinical management of CDH1 germline mutant carriers providing specific recommendations for genetic counselling, clinical criteria, surveillance and/ or prophylactic surgery.
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Affiliation(s)
- Giovanni Corso
- Molecular Senology Unit, via G. Ripamonti 435, European Institute of Oncology, 20141, Milan, Italy,
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16
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New Therapeutic Approaches for Invasive Lobular Carcinoma. CURRENT BREAST CANCER REPORTS 2014. [DOI: 10.1007/s12609-014-0158-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Pilewskie M, King TA. Magnetic resonance imaging in patients with newly diagnosed breast cancer: a review of the literature. Cancer 2014; 120:2080-9. [PMID: 24752817 DOI: 10.1002/cncr.28700] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/21/2014] [Accepted: 03/14/2014] [Indexed: 12/14/2022]
Abstract
The use of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer remains controversial. Here we review the current use of breast MRI and the impact of MRI on short-term surgical outcomes and rates of local recurrence. In addition, we address the use of MRI in specific patient populations, such as those with ductal carcinoma in situ, invasive lobular carcinoma, and occult primary breast cancer, and discuss the potential role of MRI for assessing response to neoadjuvant chemotherapy. Although MRI has improved sensitivity compared with conventional imaging, this has not translated into improved short-term surgical outcomes or long-term patient benefit, such as improved local control or survival, in any patient population. MRI is an important diagnostic test in the evaluation of patients presenting with occult primary breast cancer and has shown promise in monitoring response to neoadjuvant chemotherapy; however, the data do not support the routine use of perioperative MRI in patients with newly diagnosed breast cancer. Cancer 2014;120:120:2080-2089. © 2014 American Cancer Society.
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Affiliation(s)
- Melissa Pilewskie
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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