Skip to main content

Advertisement

SpringerLink
Log in

Comparison of magnetic resonance imaging, multidetector row computed tomography, ultrasonography, and mammography for tumor extension of breast cancer

  • Preclinical Study
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Introduction Breast imaging modalities can assess the tumor extent and adequacy of excision, but there have been no reports comparing magnetic resonance (MR) imaging, multidetector row computed tomography (MDCT), ultrasonography (US) and mammography (MMG) for the tumor extent of breast cancer. We prospectively assessed the accuracy of MR imaging, MDCT, US and MMG for preoperative assessment of the tumor extent of breast cancer. Methods Preoperative MR imaging, MDCT, US and MMG were performed for 210 breasts with breast cancer. The MR and MDCT images were independently interpreted by one of two radiologists with knowledge of the clinical and MMG findings. The US was performed with knowledge of the clinical and MMG findings by one of five US technologists. The correlation of the results of these examinations with histological findings was examined. Results Of the 210 index breast tumors, 210 (100%) could be detected on MR, 208 (99%) were detected on MDCT, 209 (99.5%) were detected on US, and 195 (93%) were detected on MMG. For evaluating local tumor extent, the accuracy of MR imaging (76%) was significantly higher than those of MDCT, US, and MMG (71%, 56%, and 52%, respectively) (P = 0.001, P < 0.0001, and P < 0.0001). MDCT was significantly more accurate than US (P < .0001) or MMG (P < .0001), and US was significantly more accurate than MMG (P = 0.004). MR imaging and US had substantial risk (11% and 17%) of overestimation of the tumor extent. Regarding ductal carcinoma in situ (DCIS), for non-comedo DCIS, the accuracies of MR imaging (89%), MDCT (72%), and US (61%) were significantly higher than the 22% accuracy of MMG (P < 0.0001, P = 0.012, and P = 0.016), but for comedo DCIS, there were no significant differences among the four breast imaging modalities. Conclusion MR imaging was the most accurate breast imaging modality for the tumor exten of breast cancer, although MR imaging had a substantial of risk of overestimation. MR imaging, MDCT and US can complement MMG for the preoperative evaluation of patients who are candidates for breast-conserving surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. NIH Cosensus Conference (1991) Treatment of early-stage breast cancer. J Am Med Assoc 265:391–395

    Article  Google Scholar 

  2. Vicini FA, Eberlein TL, Connolly JL, Recht A, Abner A, Schnitt SJ, Silen W, Harris JR (1991) The optimal extent of resection for patients with stages 1 or 2 breast cancer treated with conservative surgery and radiotherapy. Ann Sur 214:200–204

    Article  CAS  Google Scholar 

  3. Smitt MC, Nowels KW, Zdeblick MJ, Jeffrey S, Carlson RW, Stockdale FE, Goffinet DR (1995) The importance of the lumpectomy surgical margin status in long term results of breast conservation. Cancer 76:259–267

    Article  PubMed  CAS  Google Scholar 

  4. Gage I, Schnitt SJ, Nixon AJ, Silver B, Recht A, Troyan SL, Eberlein T, Love SM, Gelman R, Harris JR, Connolly JL (1996) Pathologic margin involvement and the risk of recurrence in patients treated with breast-conserving therapy. Cancer 78:1921–1928

    Article  PubMed  CAS  Google Scholar 

  5. Connolly JL, Boyages J, Nixon AJ, Peiro G, Gage I, Silver B, Recht A, Harris JR, Schnitt SJ (1998) Predictors of breast recurrence after conservative surgery and radiation therapy for invasive breast cancer. Mod Pathol 11:134–139

    PubMed  CAS  Google Scholar 

  6. Morrow M, Schmidt R, Hassett C (1995) Patient selection for breast conservation therapy with magnification mammography. Surgery 118:621–626

    Article  PubMed  CAS  Google Scholar 

  7. Satake H, Shimamoto K, Sawaki A, Niimi R, Ishiguchi T, Ishigaki T, Yamakawa K, Nagasaka T, Funahashi H (2000) Role of ultrasonography in the detection of intraductal spread of breast cancer: correlation with pathologic findings, mammography and MR imaging. Eur Radiol 10:1726–1732

    Article  PubMed  CAS  Google Scholar 

  8. Hata T, Takahashi H, Watanabe K, Takahashi M, Taguchi K, Itoh T, Toda S (2004) Magnetic resonance imaging for preoperative evaluation of breast cancer: a comparative study with mammography and ultrasonography. J Am Coll Surg 198:190–197

    Article  PubMed  Google Scholar 

  9. Berg WA, Gutierrez L, NessAiver MS, Carter WB, Bhargavan M, Lewis RS, Ioffe OB (2004) Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology 233:830–849

    Article  PubMed  Google Scholar 

  10. Uematsu T, Sano M, Homma K, Shiina M, Kobayashi S (2001) Three-dimensional helical CT of the breast: accuracy for measuring extent of breast cancer candidates for breast conserving surgery. Breast Cancer Res Treat 65:249–257

    Article  PubMed  CAS  Google Scholar 

  11. Uematsu T, Sano M, Homma K, Sato N (2004) Value of three-dimensional helical CT image-guided planning for made-to-order lumpectomy in breast cancer patients. Breast J 10:33–37

    Article  PubMed  Google Scholar 

  12. American College of Radiology (2003) Breast imaging reporting and data system (BI-RADS), 4th edn. American College of Radiology, Reston, VA

    Google Scholar 

  13. Uematsu T, Sano M, Homma K, Sato N (2002) Comparison between high-resolution helical CT and pathology in breast examination. Acta Radiol 43:385–390

    Article  PubMed  CAS  Google Scholar 

  14. Egan RL (1982) Multicentric breast carcinomas: clinical-radiographic–pathologic whole organ studies and 10-year survival. Cancer 49:1123–1130

    Article  PubMed  CAS  Google Scholar 

  15. Faverly DRG, Hendriks JHCL, Holland R (2001) Breast carcinomas of limited extend. Cancer 91:647–659

    Article  PubMed  CAS  Google Scholar 

  16. Moon WK, Myung FS, Lee YF, Park IA, Noh DY, Im FG (2002) US of ductal carcinoma in situ. RadioGraphics 22:269–281

    PubMed  Google Scholar 

  17. Holland R, Hendriks JHCL, Mravunac M (1983) Mammographically occult breast cancer. Cancer 52:1810–1819

    Article  PubMed  CAS  Google Scholar 

  18. Menell JH, Morris EA, Dershaw DD, Abramson AF, Brogi E, Liberman L (2005) Determination of the presence and extent of pure ductal carcinoma in situ by mammography and magnetic resonance imaging. Breast J 6:382–390

    Article  Google Scholar 

  19. Holland R, Hendriks JHCL, Verbeek ALM, Mravunac M, Stekhoven JHS (1990) Extent, distribution, and mammographic/histological correlations of breast ductal carcinoma in situ. Lancet 335:519–522

    Article  PubMed  CAS  Google Scholar 

  20. Krecke KN, Gisvold JJ (1993) Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients. Am J Roentgenol 161:957–960

    CAS  Google Scholar 

  21. Butler RS, Venta LA, Wiley EL, Ellis RL, Dempsey PJ, Rubin E (1999) Sonographic evaluation of infiltrating lobular carcinoma. Am J Roentgenol 172:325–330

    CAS  Google Scholar 

  22. Schelfourt K, Goethem MV, Kersschot E, Verslegers I, Biltjes I, Leyman P, Colpaert C, Thienpont L, Haute JVD, Gillardin JP, Tjalma W, Buytaert P, Schepper AD (2004) Preoperative breast MRI in patients with invasive lobular breast cancer. Eur Radiol 14:1209–1216

    Google Scholar 

  23. Weinstein SP, Orel SG, Heller R, Reynolds C, Czerniecki B, Solin LJ, Schnall M (2001) MR imaging of the breast in patients with invasive lobular carcinoma. Am J Roentgenol 176:399–406

    CAS  Google Scholar 

  24. Rodenko GN, Harms SE, Pruneda JM, Farrell RS, Evans WP, Copit DS, Krakos PA, Flamig DP (1996) MR imaging in the management before surgery of lobular carcinoma of the breast: correlation with pathology. Am J Roentgenol 167:1415–1419

    CAS  Google Scholar 

  25. Kawashima M, Tamaki Y, Nonaka T, Higuchi K, Kimura M, Koida T, Yanagita Y, Sugihara S (2002) MR imaging of mucinous carcinoma of the breast. Am J Roentgenol 179:179–183

    Google Scholar 

  26. Uematsu T, Sano M, Homma K, Makino H, Shiina M, Kobayashi S, Shimizu K (2001) Staging of palpable T1–2 invasive breast cancer with helical CT. Breast Cancer 8:125–130

    Article  PubMed  CAS  Google Scholar 

  27. Saranelli F, Giuseppetti GM, Panizza P, Bazzocchi M, Fausto A, Simonetti G, Lattanzio V, Maschio AD (2004) Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in fatty and dense breasts using the whole-breast pathologic examination as a gold standard. Am J Roentgenol 183:1149–1157

    Google Scholar 

  28. Holland R, Hendriks JHCL (1994) Microcalcifications associated with ductal carcinoma in situ: mammographic-pathologic correlation. Semin Diagn Surg Pathol 11:181–192

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Breast Imaging Section, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan

    Takayoshi Uematsu & Sachiko Yuen

  2. Department of Pathology, Shizuoka Cancer Center Hospital, Naga-izumi, Japan

    Masako Kasami

  3. Division of Breast Surgery, Shizuoka Cancer Center Hospital, Naga-izumi, Japan

    Yoshihiro Uchida

Authors
  1. Takayoshi Uematsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sachiko Yuen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masako Kasami
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshihiro Uchida
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takayoshi Uematsu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Uematsu, T., Yuen, S., Kasami, M. et al. Comparison of magnetic resonance imaging, multidetector row computed tomography, ultrasonography, and mammography for tumor extension of breast cancer. Breast Cancer Res Treat 112, 461–474 (2008). https://doi.org/10.1007/s10549-008-9890-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-008-9890-y

Keywords

Search

Navigation