Diagnostic Accuracy of MRI in Breast Cancer-A Study of 156 Cases

ABSTRACT

Background: Background- MRI helps in detection of multicentric and multifocal disease in the same breast as well as in identification of synchronous lesions in contralateral breast. MRI imaging done with dedicated breast coil and thin section imaging of the axilla is an effective tool in determining the axillary lymph node metastasis in newly diagnosed cases of breast cancer. Aims-To study those interpretation criteria of MRI that serve to increase the sensitivity and specificity of identifying non-mass like enhancement, multi centricity and nodal characteristics in breast cancer patients undergoing breast conservation surgery. Methods: Retrospective analysis of 156 patients was conducted in the Department of Radio diagnosis; Max Hospital, New Delhi, from September 2011 to June 2014. Both were correlated for tumor size, multifocality, multicentricity, extension of DCIS, nodal characteristics, extension to nipple and contralateral breast lesions. Results: In our study, detection of NMLE on MRI had a sensitivity of 89% and specificity of 78%. Lymph nodes with cortical thickening had a higher sensitivity (86% vs 65%) but lower specificity (69 % vs 89 %) than fatty hilum. Sensitivity was high for post lumpectomy with positive surgical margins and post NACT patients (100%). Conclusion: MRI has a high sensitivity in detection of breast cancer lesions. The detection of multicentric/ multifocal lesions in the same as well as contralateral breast and non-mass like enhancements is critical in deciding breast conservation surgery.