Breast MRI in Community Practice

Abstract

ABSTRACT
Background: Breast cancer is the most common cancer and second leading cause of
cancer-related deaths in women globally; this necessitates proper screening and early
diagnostic techniques to reduce the morbidity and mortality associated with this disease
including self examination, clinical examination, ultrasound, mammography and MRI
breast studies.
Objectives: This article focuses on the role of MRI in diagnosis, screening, management
and follow up of breast diseases, and reviews the current indications for breast MRI.
Methods: Two hundred thirty three cases with variable breast diseases attending breast
clinic in Al-Karama Teaching Hospital or our private clinics were included in the study
during the period from April 2011 till January 2014; one hundred ten cases underwent MRI
for breast were chosen as a studied group while one hundred twenty three cases who
underwent only breast sonar and mammographic study were considered as a control
group in the same period and places.
Results: In the studied group: Change in surgical therapy plan due to MRI findings in
cases with histologically proved breast cancer was seen in (62.5%) of cases and change
in staging was seen in (15%) of them. MRI, also, detected lesions in (52.5%) of cases with
inconclusive mammographic breast cases that proved to be malignant in (40%) of them.
Cases with metastatic lymphadenopathy of an unknown primary malignancy and
undetected breast lesion showed breast lesion in (62.5% ) of cases proved to be
malignant later in (50%) of them.
Conclusion: Breast MRI has paved the way for new thinking regarding the workup of
women recently diagnosed with breast cancer, further more in screening of high-risk
women using both breast MRI and mammography for breast cancer screening is likely to
improve the early detection of breast cancer. The use of MRI preoperatively is advocated
also in women with dense breasts where mammography is significantly less sensitive for
the detection of malignancy or in those patients with axillary nodal adenocarcinoma to
identify the primary malignancy.