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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Defining an optimal role for breast magnetic resonance imaging when evaluating patients otherwise eligible for accelerated partial breast irradiation
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Defining an optimal role for breast magnetic resonance imaging when evaluating patients otherwise eligible for accelerated partial breast irradiation

机译：在评估有资格进行加速局部乳房照射的患者时，确定乳房磁共振成像的最佳作用

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Background and purpose Pre-treatment breast magnetic resonance imaging (MRI) findings in a cohort of women prospectively evaluated for accelerated partial breast irradiation (APBI) are reviewed and characterized to determine the optimal use of MRI in these patients. Materials and methods Candidates initially deemed eligible for a prospective APBI trial based on physical examination, mammography, and ultrasound (US) were further evaluated with breast MRI before treatment. All abnormal MRI findings were biopsied. Results Between 2002 and 2011, 180 women who met inclusion criteria for APBI underwent breast MRI prior to treatment (median age = 59; range 38-86). 126 tumors (70%) were invasive carcinomas with or without associated DCIS, while 54 (30%) were pure DCIS. Breast MRI confirmed unifocal disease in 109 patients with 111 cancers (60.5% of MRI cohort). Multifocal disease was identified in 19 patients (10.5% of MRI cohort), while multicentric disease was present in 3 patients (1.6% of MRI cohort). Five patients (4%) had an MRI-detected contralateral cancer. False positive MRI findings were seen in 45 patients (25% of MRI cohort). Pre-menopausal patients and patients with tumors >2 cm were more likely to have MRI-detected multifocal/multicentric disease. While there was no statistically significant correlation between multifocal/multicentric disease and breast density, tumor histology, grade, ER status, or Her2/Neu expression, numbers in each category were small, suggesting a lack of statistical power to detect differences that may be clinically meaningful. One hundred and fifty-two of the 180 patients (84.4%) successfully completed lumpectomy and APBI, while 6.7% of the cohort underwent mastectomy. Conclusions Breast MRI identified additional disease in 12% of APBI candidates. Premenopausal women and patients with tumors >2 cm were more likely to have MRI-detected multifocal/ multicentric disease.
机译：背景和目的回顾性评估了一组女性的治疗前乳房磁共振成像（MRI）的发现，这些女性均经过了局部局部加速辐照（APBI）评估，并确定了这些患者中MRI的最佳用途。材料和方法在治疗前，首先根据乳腺MRI对根据体格检查，乳房X线照片和超声检查（US）被认为有资格参加前瞻性APBI试验的候选人进行进一步评估。对所有异常MRI检查结果进行活检。结果在2002年至2011年之间，有180例符合APBI入选标准的妇女在接受治疗前接受了乳房MRI检查（中位年龄= 59;范围38-86）。 126例肿瘤（占70％）是伴有或不伴有DCIS的浸润性癌，而54例（30％）是单纯DCIS。乳房MRI在109例111例癌症患者中证实了单灶性疾病（占MRI队列的60.5％）。在19例患者中发现了多灶性疾病（占MRI队列的10.5％），而在3例患者中发现了多中心疾病（占MRI队列的1.6％）。五名患者（占4％）患有MRI检测到的对侧癌。在45例患者中发现了MRI假阳性结果（占MRI队列的25％）。绝经前患者和肿瘤> 2 cm的患者更有可能患有MRI检测到的多灶性/多中心性疾病。尽管多灶性/多中心性疾病与乳房密度，肿瘤组织学，等级，ER状态或Her2 / Neu表达之间在统计学上无显着相关性，但每个类别中的数目均很小，这表明缺乏统计能力来检测可能存在临床差异的疾病有意义的。 180例患者中有152例（84.4％）成功完成了乳房切除术和APBI，而该队列中有6.7％接受了乳房切除术。结论乳房MRI在12％的APBI候选人中发现了其他疾病。绝经前妇女和肿瘤> 2 cm的患者更有可能患有MRI检测的多灶性/多中心性疾病。

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