Application Study Of Preoperative Dynamic Contrast Enhanced-MRI For Breast Cancer In Breast-conserving Therapy

Objective: To investigate the correlations of magnetic resonance imaging(MRI)for breast cancer at different modes of dynamic contrast enhancement with surgical changes during breast-conserving therapy(BCT),providing help for surgical options.Methods: 269 enhancing patterns on DCE-MRI scans were selected,and subdivided into the following groups:(1)a single mass-like enhancement,(2)a single non-mass-like enhancement(NME),(3)mass-like enhancing breast cancer with other mass-like enhancing lesions,and(4)mass-like enhancing breast cancer with additional NMEs.Associations between enhancing patterns on DCE-MRI and re-excision rate,size of specimen,and ratio of tumor/specimen were evaluated retrospectively.Results: The conversion rate from breast conserving therapy(BCT)to mastectomy as a result of MRI findings was 13.4%,re-excision rate during BCT was 8.2% and excision rate of another suspicious lesion was 7.4%.The single NME group had the highest re-excision rate after BCT(22.2%)(P=0.02).The ratio of tumor/specimen(P=0.61)and mean specimen size(P=0.38)were not influenced by enhancement patterns.The false positive rate and positive predictive values of using DCEMRI for defining the extension of breast cancer was 22.2% and 71.4%,respectively.Conclusion: Different preoperative DCE-MRI modes for breast cancer can reduce the resection rate of single NME.Preoperative breast MRI can provide more valuable clinical information,even change the first surgical plan.Breast MRI examination is expected to assist clinical treatment,and will play an important role in preoperative evaluation of breast cancer.