Magnetic resonance imaging facilitates breast conservation for occult breast cancer
Occult primary breast cancer, i.e., isolated axillary adenocarcinoma without detectable tumor in the breast by either physical exam or mammography, represents up to 1% of operable breast cancer. Modified radical mastectomy (MRM) is generally the accepted treatment for this condition although tumor i...
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| Veröffentlicht in: | Annals of surgical oncology 2000-07, Vol.7 (6), p.411-415 |
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| creator | Olson, Jr, J A Morris, E A Van Zee, K J Linehan, D C Borgen, P I |
| description | Occult primary breast cancer, i.e., isolated axillary adenocarcinoma without detectable tumor in the breast by either physical exam or mammography, represents up to 1% of operable breast cancer. Modified radical mastectomy (MRM) is generally the accepted treatment for this condition although tumor is identified in only two-thirds of mastectomy specimens. Breast magnetic resonance imaging (MRI) can identify occult breast carcinoma and may direct therapy. This study examined the ability of breast MRI to detect occult breast cancer and to facilitate breast conservation therapy.
Forty women with biopsy-proven metastatic adenocarcinoma to an axillary lymph node and no evidence of primary cancer were studied. All patients had a physical examination, mammography, and MRI of the breast. Using a dedicated breast coil, MRI imaging was performed with and without gadolinium enhancement. Positive MRI scans were compared with histopathologic findings at the time of operation (n = 21).
MRI identified the primary breast lesion in 28 of 40 women (70%). Of these 28 patients, 11 had MRM, 11 had lumpectomy/axillary lymph node dissection (ALND)/radiotherapy (XRT), 2 had ALND/XRT alone, and 4 had no local treatment secondary to stage IV disease. Two women initially treated with lumpectomy/ALND subsequently had mastectomy for positive margins. Of the women with positive MRI who had breast surgery, 21 of 22 (95%) had tumor within the surgical specimen. Twelve women had negative MRI of the breast. Five of these 12 underwent MRM, of whom 4 had no tumor in the mastectomy specimen. The remaining 7 patients had ALND and whole breast radiation (ALND/XRT) (n = 5), or were observed (n = 2). Overall, 18 of 34 women surgically treated had MRM, while 16 (47%) preserved their breast. Tumor yield for patients having breast surgery was 81%.
MRI of the breast can identify occult breast cancer in many patients and may facilitate breast conservation in select women. Negative breast MRI predicts low tumor yield at mastectomy. |
| doi_str_mv | 10.1007/s10434-000-0411-4 |
| format | Article |
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Forty women with biopsy-proven metastatic adenocarcinoma to an axillary lymph node and no evidence of primary cancer were studied. All patients had a physical examination, mammography, and MRI of the breast. Using a dedicated breast coil, MRI imaging was performed with and without gadolinium enhancement. Positive MRI scans were compared with histopathologic findings at the time of operation (n = 21).
MRI identified the primary breast lesion in 28 of 40 women (70%). Of these 28 patients, 11 had MRM, 11 had lumpectomy/axillary lymph node dissection (ALND)/radiotherapy (XRT), 2 had ALND/XRT alone, and 4 had no local treatment secondary to stage IV disease. Two women initially treated with lumpectomy/ALND subsequently had mastectomy for positive margins. Of the women with positive MRI who had breast surgery, 21 of 22 (95%) had tumor within the surgical specimen. Twelve women had negative MRI of the breast. Five of these 12 underwent MRM, of whom 4 had no tumor in the mastectomy specimen. The remaining 7 patients had ALND and whole breast radiation (ALND/XRT) (n = 5), or were observed (n = 2). Overall, 18 of 34 women surgically treated had MRM, while 16 (47%) preserved their breast. Tumor yield for patients having breast surgery was 81%.
MRI of the breast can identify occult breast cancer in many patients and may facilitate breast conservation in select women. Negative breast MRI predicts low tumor yield at mastectomy.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1007/s10434-000-0411-4</identifier><identifier>PMID: 10894136</identifier><language>eng</language><publisher>United States: Springer Nature B.V</publisher><subject>Adenocarcinoma ; Adenocarcinoma - diagnosis ; Adenocarcinoma - secondary ; Adenocarcinoma - surgery ; Adult ; Aged ; Axilla - pathology ; Biopsy ; Breast - pathology ; Breast cancer ; Breast carcinoma ; Breast Neoplasms - diagnosis ; Breast Neoplasms - surgery ; Breast surgery ; Cancer therapies ; Female ; Gadolinium ; Humans ; Lumpectomy ; Lymph nodes ; Lymphatic system ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Mammography ; Mastectomy ; Mastectomy, Modified Radical - methods ; Metastases ; Middle Aged ; Neoplasms, Unknown Primary - diagnosis ; Patients ; Predictive Value of Tests ; Radiation therapy ; Sensitivity and Specificity ; Surgery ; Survival Analysis</subject><ispartof>Annals of surgical oncology, 2000-07, Vol.7 (6), p.411-415</ispartof><rights>The Society of Surgical Oncology, Inc. 2000.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-5bd83551f5141b93b301f28f54a103bb02b703d684ce2dcf89a54acb40a8e3113</citedby><cites>FETCH-LOGICAL-c391t-5bd83551f5141b93b301f28f54a103bb02b703d684ce2dcf89a54acb40a8e3113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10894136$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Olson, Jr, J A</creatorcontrib><creatorcontrib>Morris, E A</creatorcontrib><creatorcontrib>Van Zee, K J</creatorcontrib><creatorcontrib>Linehan, D C</creatorcontrib><creatorcontrib>Borgen, P I</creatorcontrib><title>Magnetic resonance imaging facilitates breast conservation for occult breast cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><description>Occult primary breast cancer, i.e., isolated axillary adenocarcinoma without detectable tumor in the breast by either physical exam or mammography, represents up to 1% of operable breast cancer. Modified radical mastectomy (MRM) is generally the accepted treatment for this condition although tumor is identified in only two-thirds of mastectomy specimens. Breast magnetic resonance imaging (MRI) can identify occult breast carcinoma and may direct therapy. This study examined the ability of breast MRI to detect occult breast cancer and to facilitate breast conservation therapy.
Forty women with biopsy-proven metastatic adenocarcinoma to an axillary lymph node and no evidence of primary cancer were studied. All patients had a physical examination, mammography, and MRI of the breast. Using a dedicated breast coil, MRI imaging was performed with and without gadolinium enhancement. Positive MRI scans were compared with histopathologic findings at the time of operation (n = 21).
MRI identified the primary breast lesion in 28 of 40 women (70%). Of these 28 patients, 11 had MRM, 11 had lumpectomy/axillary lymph node dissection (ALND)/radiotherapy (XRT), 2 had ALND/XRT alone, and 4 had no local treatment secondary to stage IV disease. Two women initially treated with lumpectomy/ALND subsequently had mastectomy for positive margins. Of the women with positive MRI who had breast surgery, 21 of 22 (95%) had tumor within the surgical specimen. Twelve women had negative MRI of the breast. Five of these 12 underwent MRM, of whom 4 had no tumor in the mastectomy specimen. The remaining 7 patients had ALND and whole breast radiation (ALND/XRT) (n = 5), or were observed (n = 2). Overall, 18 of 34 women surgically treated had MRM, while 16 (47%) preserved their breast. Tumor yield for patients having breast surgery was 81%.
MRI of the breast can identify occult breast cancer in many patients and may facilitate breast conservation in select women. Negative breast MRI predicts low tumor yield at mastectomy.</description><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - diagnosis</subject><subject>Adenocarcinoma - secondary</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Axilla - pathology</subject><subject>Biopsy</subject><subject>Breast - pathology</subject><subject>Breast cancer</subject><subject>Breast carcinoma</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast surgery</subject><subject>Cancer therapies</subject><subject>Female</subject><subject>Gadolinium</subject><subject>Humans</subject><subject>Lumpectomy</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Mammography</subject><subject>Mastectomy</subject><subject>Mastectomy, Modified Radical - methods</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Neoplasms, Unknown Primary - diagnosis</subject><subject>Patients</subject><subject>Predictive Value of Tests</subject><subject>Radiation therapy</subject><subject>Sensitivity and Specificity</subject><subject>Surgery</subject><subject>Survival Analysis</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkE1LxDAQhoMorq7-AC9SELxVZ5qkTY-y-AUrHtRzSNJ06dJN1qQV_Pdm6SLiaYZ5PxgeQi4QbhCguo0IjLIcAHJgiDk7ICfI04WVAg_TDqXI66LkM3Ia4xoAKwr8mMwQRM2Qlifk7UWtnB06kwUbvVPO2KzbqFXnVlmrTNd3gxpszHSwKg6Z8S7a8KWGzrus9SHzxoz98Cvv8uGMHLWqj_Z8P-fk4-H-ffGUL18fnxd3y9zQGoec60ZQzrHlyFDXVFPAthAtZwqBag2FroA2pWDGFo1pRa2SZDQDJSxFpHNyPfVug_8cbRzkpovG9r1y1o9RVlgUosQyGa_-Gdd-DC79JguGnFdIeZVcOLlM8DEG28ptSCjCt0SQO95y4i0Tb7njLVnKXO6bR72xzZ_EBJj-ANSiesQ</recordid><startdate>20000701</startdate><enddate>20000701</enddate><creator>Olson, Jr, J A</creator><creator>Morris, E A</creator><creator>Van Zee, K J</creator><creator>Linehan, D C</creator><creator>Borgen, P I</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20000701</creationdate><title>Magnetic resonance imaging facilitates breast conservation for occult breast cancer</title><author>Olson, Jr, J A ; Morris, E A ; Van Zee, K J ; Linehan, D C ; Borgen, P I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-5bd83551f5141b93b301f28f54a103bb02b703d684ce2dcf89a54acb40a8e3113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adenocarcinoma</topic><topic>Adenocarcinoma - diagnosis</topic><topic>Adenocarcinoma - secondary</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Axilla - pathology</topic><topic>Biopsy</topic><topic>Breast - pathology</topic><topic>Breast cancer</topic><topic>Breast carcinoma</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast surgery</topic><topic>Cancer therapies</topic><topic>Female</topic><topic>Gadolinium</topic><topic>Humans</topic><topic>Lumpectomy</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Mammography</topic><topic>Mastectomy</topic><topic>Mastectomy, Modified Radical - methods</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Neoplasms, Unknown Primary - diagnosis</topic><topic>Patients</topic><topic>Predictive Value of Tests</topic><topic>Radiation therapy</topic><topic>Sensitivity and Specificity</topic><topic>Surgery</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Olson, Jr, J A</creatorcontrib><creatorcontrib>Morris, E A</creatorcontrib><creatorcontrib>Van Zee, K J</creatorcontrib><creatorcontrib>Linehan, D C</creatorcontrib><creatorcontrib>Borgen, P I</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Olson, Jr, J A</au><au>Morris, E A</au><au>Van Zee, K J</au><au>Linehan, D C</au><au>Borgen, P I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic resonance imaging facilitates breast conservation for occult breast cancer</atitle><jtitle>Annals of surgical oncology</jtitle><addtitle>Ann Surg Oncol</addtitle><date>2000-07-01</date><risdate>2000</risdate><volume>7</volume><issue>6</issue><spage>411</spage><epage>415</epage><pages>411-415</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Occult primary breast cancer, i.e., isolated axillary adenocarcinoma without detectable tumor in the breast by either physical exam or mammography, represents up to 1% of operable breast cancer. Modified radical mastectomy (MRM) is generally the accepted treatment for this condition although tumor is identified in only two-thirds of mastectomy specimens. Breast magnetic resonance imaging (MRI) can identify occult breast carcinoma and may direct therapy. This study examined the ability of breast MRI to detect occult breast cancer and to facilitate breast conservation therapy.
Forty women with biopsy-proven metastatic adenocarcinoma to an axillary lymph node and no evidence of primary cancer were studied. All patients had a physical examination, mammography, and MRI of the breast. Using a dedicated breast coil, MRI imaging was performed with and without gadolinium enhancement. Positive MRI scans were compared with histopathologic findings at the time of operation (n = 21).
MRI identified the primary breast lesion in 28 of 40 women (70%). Of these 28 patients, 11 had MRM, 11 had lumpectomy/axillary lymph node dissection (ALND)/radiotherapy (XRT), 2 had ALND/XRT alone, and 4 had no local treatment secondary to stage IV disease. Two women initially treated with lumpectomy/ALND subsequently had mastectomy for positive margins. Of the women with positive MRI who had breast surgery, 21 of 22 (95%) had tumor within the surgical specimen. Twelve women had negative MRI of the breast. Five of these 12 underwent MRM, of whom 4 had no tumor in the mastectomy specimen. The remaining 7 patients had ALND and whole breast radiation (ALND/XRT) (n = 5), or were observed (n = 2). Overall, 18 of 34 women surgically treated had MRM, while 16 (47%) preserved their breast. Tumor yield for patients having breast surgery was 81%.
MRI of the breast can identify occult breast cancer in many patients and may facilitate breast conservation in select women. Negative breast MRI predicts low tumor yield at mastectomy.</abstract><cop>United States</cop><pub>Springer Nature B.V</pub><pmid>10894136</pmid><doi>10.1007/s10434-000-0411-4</doi><tpages>5</tpages></addata></record> |
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| subjects | Adenocarcinoma Adenocarcinoma - diagnosis Adenocarcinoma - secondary Adenocarcinoma - surgery Adult Aged Axilla - pathology Biopsy Breast - pathology Breast cancer Breast carcinoma Breast Neoplasms - diagnosis Breast Neoplasms - surgery Breast surgery Cancer therapies Female Gadolinium Humans Lumpectomy Lymph nodes Lymphatic system Magnetic resonance imaging Magnetic Resonance Imaging - methods Mammography Mastectomy Mastectomy, Modified Radical - methods Metastases Middle Aged Neoplasms, Unknown Primary - diagnosis Patients Predictive Value of Tests Radiation therapy Sensitivity and Specificity Surgery Survival Analysis |
| title | Magnetic resonance imaging facilitates breast conservation for occult breast cancer |
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