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- Title
Feasibility of mapping breast cancer with supine breast MRI in patients scheduled for oncoplastic surgery.
- Authors
Joukainen, S.; Masarwah, A.; Könönen, M.; Husso, M.; Sutela, A.; Kärjä, V.; Vanninen, R.; Sudah, M.
- Abstract
<bold>Objectives: </bold>To prospectively determine the feasibility of preoperative supine breast MRI in breast cancer patients scheduled for oncoplastic breast-conserving surgery.<bold>Methods: </bold>In addition to a diagnostic prone breast MRI, a supplementary supine MRI was performed with the patient in the surgical position including skin markers. Tumours' locations were ink-marked on the skin according to findings obtained from supine MRI. Changes in tumours' largest diameter and locations between prone and supine MRI were measured and compared to histology. Nipple-to-tumour and tumour-to-chest wall distances were also measured. Tumours and suspicious areas were surgically removed according to skin ink-markings. The differences between MRI measurements with reference to histopathology were evaluated with the paired-sample t test.<bold>Results: </bold>Fourteen consecutive patients, 15 breasts and 27 lesions were analysed. Compared to histology, prone MRI overestimated tumour size by 47.1% (p = 0.01) and supine MRI by 14.5% (p = 0.259). In supine MRI, lesions' mean diameters and areas were smaller compared to prone MRI (- 20.9%, p = 0.009 and - 38.3%, p = 0.016, respectively). This difference in diameter was more pronounced in non-mass lesions (- 31.2%, p = 0.031) compared to mass lesions (- 9.2%, p = 0.009). Tumours' mean distance from chest wall diminished by 69.4% (p < 0.001) and from nipple by 18.2% (p < 0.001). Free microscopic margins were achieved in first operation in all patients.<bold>Conclusions: </bold>Supine MRI in the surgical position is feasible and useful in the precise localisation of prone MRI-detected lesions and provides a helpful tool to implement in surgery. Supine MRI more accurately determines tumours' size and location and might have an important role to diminish overestimations.<bold>Key Points: </bold>• Breath-hold supine breast MRI is feasible using commercially available coils and sequences. • Size and area of lesions on MRI were consistently smaller when measured from the supine position as compared to the prone position. • Supine breast MRI is useful in the precise preoperative localisation of prone MRI-detected lesions. •.
- Subjects
BREAST tumor diagnosis; BREAST tumors; COMPARATIVE studies; MAGNETIC resonance imaging; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH evaluation; SUPINE position; PILOT projects; LUMPECTOMY; EVALUATION research
- Publication
European Radiology, 2019, Vol 29, Issue 3, p1435
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5681-y