Details

Autor(en) / Beteiligte

• Joukainen, S.
• Masarwah, A.
• Könönen, M.
• Husso, M.
• Sutela, A.
• Kärjä, V.
• Vanninen, R.
• Sudah, M.

Titel

Feasibility of mapping breast cancer with supine breast MRI in patients scheduled for oncoplastic surgery

Ist Teil von

• European radiology, 2019-03, Vol.29 (3), p.1435-1443

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Objectives To prospectively determine the feasibility of preoperative supine breast MRI in breast cancer patients scheduled for oncoplastic breast-conserving surgery. Methods In addition to a diagnostic prone breast MRI, a supplementary supine MRI was performed with the patient in the surgical position including skin markers. Tumours’ locations were ink-marked on the skin according to findings obtained from supine MRI. Changes in tumours’ largest diameter and locations between prone and supine MRI were measured and compared to histology. Nipple-to-tumour and tumour-to-chest wall distances were also measured. Tumours and suspicious areas were surgically removed according to skin ink-markings. The differences between MRI measurements with reference to histopathology were evaluated with the paired-sample t test. Results Fourteen consecutive patients, 15 breasts and 27 lesions were analysed. Compared to histology, prone MRI overestimated tumour size by 47.1% ( p = 0.01) and supine MRI by 14.5% ( p = 0.259). In supine MRI, lesions’ mean diameters and areas were smaller compared to prone MRI (– 20.9%, p = 0.009 and – 38.3%, p = 0.016, respectively). This difference in diameter was more pronounced in non-mass lesions (– 31.2%, p = 0.031) compared to mass lesions (– 9.2%, p = 0.009). Tumours’ mean distance from chest wall diminished by 69.4% ( p < 0.001) and from nipple by 18.2% ( p < 0.001). Free microscopic margins were achieved in first operation in all patients. Conclusions Supine MRI in the surgical position is feasible and useful in the precise localisation of prone MRI-detected lesions and provides a helpful tool to implement in surgery. Supine MRI more accurately determines tumours’ size and location and might have an important role to diminish overestimations. Key Points • Breath-hold supine breast MRI is feasible using commercially available coils and sequences. • Size and area of lesions on MRI were consistently smaller when measured from the supine position as compared to the prone position. • Supine breast MRI is useful in the precise preoperative localisation of prone MRI-detected lesions. •