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Breast Magnetic Resonance Imaging of Multicentric, Multifocal and Bilateral Cancer

but did not fully answer whether pre-operative breast MRI adds benefit because recurrence and overall survival rates were not examined.

unnecessary,63 Specifically in terms of the recurrence rate, Fisher et al.27 obtained

better results: 1.2% recurrences in patients with a pre-surgical MRI versus 6.8% in women without it. The rate of undetected contralateral carcinomas in the follow-up was 1.7% in women with pre-surgical MRI versus 4% of women without MRI. Nevertheless, Drew et al.64

recurrence rate, and Solin et al.59

did not see any impact of pre-surgical MRI on the local did not observe any difference in

the incidence of contralateral carcinoma in patients with or without pre-surgical MRI. All these studies indicate that there is still no consensus about the impact of MRI on recurrence rate. On the other hand, the new techniques of minimally invasive treatment, such as radiofrequency, microwaves, high-intensity focused ultrasound and

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partial breast radiotherapy instead of radiotherapy of the whole breast, will require a very accurate technique for staging – and that technique will certainly be MRI.15


Breast MRI is the most sensitive imaging modality for the detection of invasive carcinoma3,11,27,29,37

remainder of the conventional imaging techniques.7,62

and must be evaluated together with the It plays an

essential role in the detection of additional tumour foci, especially in young women with a family history of breast cancer, those with dense breasts and women with primary lobular carcinoma.3,11,27,29,37 MRI can modify the surgical approach in these patients,35,37,48,55,62

Findings in so

radiologists should be aware of false-positives that can lead to unnecessary biopsies or surgeries and more aggressive treatments. The impact of pre-surgical staging MRI on the rate of re-operation, recurrences and survival, remains controversial. n

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28. Solin LJ, Breast conservation treatment with radiation: an ongoing success story, J Clin Oncol, 2010;28(5):709–11.

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30. Mann RM, The effectiveness of MR imaging in the assessment of invasive lobular carcinoma of the breast, Magn Reson Imaging Clin North Am, 2010;18(2):259–76, ix.

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32. Pengel KE, Loo CE, Teertstra HJ, et al., The impact of preoperative MRI on breast-conserving surgery of invasive cancer: a comparative cohort study, Breast Cancer Res Treat, 2009;116(1):161–9.

33. Houssami N, Hayes DF, Review of preoperative magnetic resonance imaging (MRI) in breast cancer: should MRI be performed on all women with newly diagnosed, early stage breast cancer? CA Cancer J Clin, 2009;59:290–302.

34. Solin LJ, Counterview: pre-operative breast MRI (magnetic resonance imaging) is not recommended for all patients with newly diagnosed breast cancer, Breast, 2010;19:7–9.

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37. Tillman GF, Orel SG, Schnall MD, et al., Effect of breast magnetic resonance imaging on the clinical management of women with early-stage breast carcinoma, J Clin Oncol, 2002;20:3413–23.

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