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Bs11 the role of pre-operative MRI in patients with invasive lobular carcinoma of breast.

Edirimanne S, McKenzie K, Wells S, Dijkstra B

Christchurch Hospital, Christchurch, New Zealand.

Background Conventional breast imaging with mammography and ultrasonography have a tendency to underestimate the extent of invasive lobular carcinoma (ILC) of the breast. The aim of the study is to determine the role of routine pre-operative breast MRI in treatment of patients with ILC of breast. Methods 33 patients with ILC and 6 patients with pleomorphic lobular cancer (PLC) of the breast had pre-operative contrast enhanced MRI of the breasts. Suspicious additional foci were evaluated with focussed ultrasound and biopsy, selectively in ipsilateral breast and routinely in contralateral breast. The histological results of additional foci were correlated with MRI findings to determine the accuracy. Results In 1 patient (3%) index tumour was detected only by MRI. In ipsilateral breast, additional foci were found in 16 patients (41%) that led to more extensive surgery in 13 patients (33%) with a false positive rate of 15%. In the contralateral breast MRI detected suspicious foci in 7 patients (18%) and malignancy was confirmed by biopsy in 1 patient (false positive rate 86%). Conclusions In patients with ILC or PLC routine pre-operative MRI alters management of ipsilateral breast significantly with a high accuracy. Due to high false positive rate contralateral breast surgery should not be undertaken based on MRI finding only without biopsy confirmation.

Published 10 May 2007 in ANZ J Surg, 77: A3.
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