Yüksek Risk Grubu Olgularda Meme MR Görüntülemenin Mamografik Bulgulara Katkısı

Yıl 2014, Cilt: 15 Sayı: 2, 156 - 163, 01.08.2014

Melisa Yalcınkaya Makbule Varer Aysegul Sarsılmaz Gulten Sezgın Melda Apaydın Ummuhan Ozelcı Fazıl Gelal Orhan Oyar

Öz

Objective: We aimed to examine the contribution of breast magnetic resonance imaging (MRI) to mammography in high-risk patients with partial mastectomy, and/or with a family history. Material and Methods: 80 patients were scanned with mammography and MRI at our hospital. 30 of the patients had partial mastectomy due to the diagnosis of breast cancer. 52 patients had family history of breast cancer. Mammography scannings were performed under normal circumstances in standard craniocaudal (CC) and mediolateral (MLO) positions or in some special circumstances, scanings were performed using spot and magnification graphies. MRI scannings were performed using 1.5 Tesla MRI scanner with dual breast coil. Results: Fifty two of the patients enrolled in this study had a relative with breast cancer. 30 (37,5 %) out of 80 patients had history of breast cancer before. In 12 (15 %) out of 80 patients, the advantage of breast MRI to mammography could not be proven. In 54 (67,5 %) of the patients breast MRI had an advantage over mammography. In 5 (6,5 %) of the patients MRI had false negative results when compared with the pathology results. When compared with the pathology results in 9 (19 %) patients MRI scanning results were false positive. Conclusion: In this study, it was concluded that breast MRI scanning has reasonable advantage when compared to mammography for the patients who had breast cancer diagnosis or who has a first degree relative with breast cancer

Anahtar Kelimeler

Breast cancer; mammography; magnetic resonance imaging

Yüksek Risk Grubu Olgularda Meme MR Görüntülemenin Mamografik Bulgulara Katkısı

Öz

Amaç: Meme kanseri nedeniyle parsiyel mastektomi veya aile öyküsü gibi, meme kanseri için yüksek risk grubu olgularda, meme manyetik rezonans görüntüleme (MRG)’nin mamografik görüntülemeye katkısını değerlendirmeyi amaçladık. Gereç ve Yöntem: Seksen olgu, bölümümüzde mamografi ve MRG ile değerlendirildi. 30 olgu, meme kanseri tanısı ile parsiyel mastektomi geçirmişti. 52 olgu, birinci derecede akrabada meme kanseri öyküsüne sahipti. Mamografik görüntüleme, standart kraniokaudal ve mediolateral pozisyonlarda elde olundu. Gerekli durumlarda spot ve magnifiye grafiler eklendi. MR görüntüleri, 1,5 Tesla MRG cihazında, dual meme koili ile elde edildi. Bulgular: Elli iki olguda aile öyküsü mevcuttu. 30(% 37,5) olguda daha önce geçirilmiş meme kanseri ve tedavi öyküsü vardı. 80 olgudan, 12'sinde (% 15), meme MRG görüntülemenin mamografi bulgularına herhangi katkısı veya ek bulgu saptanmadı. 54 (% 67,5) olguda, MRG, mamografi bulgularına ek bulgu ve tanıya katkı sağladı. Patoloji sonuçlarıyla kıyaslandığında, 5 (% 6,5) olguda MRG'de yanlış negatif, 9 olguda (% 19) yanlış pozitif bulgular saptandı. Sonuç: Bu çalışmada, birinci derece akrabalarında meme kanseri öyküsü veya geçirilmiş meme kanseri tanı ve tedavi öyküsü bilinen, yüksek riskli olgu grubunda, meme MRG görüntülemenin, mamografik bulgulara katkı sağladığını saptadık

Anahtar Kelimeler

Meme kanseri; mamografi; manyetik rezonans görüntüleme

Kaynakça

• Harris JR, Lippman ME, Morrow M, Hellman S. Diseases of the breast. 3rd Edition, Philadelphia: Lippincott Williams &Wilkins, 2000:445-80.
• Harms SE, Flaming DP, Hesley KL, Evans WP. Mag- netic resonance imaging of the breast. Magn Reson Q 1992;8(3):139-55.
• Henteleff HJ, Hunt KK, Quan ML; Evidence-Based Reviews in Surgery Group. Comparative effectiveness of magnetic resonance imaging in breast cancer. J Am Coll Surg 2012;215(6):894-6.
• Skandarajah AR, Mann GB. The role of magnetic resonance imaging in early breast cancer. Asia- Pacific Journal of Clinical Oncology 2012;8(1):24-30.
• Morris EA. Breast cancer imaging with MRI. Radiol Clin Nort Am 2002;40(3):443-6.
• Serrano LF, Morell B, Mai A. Contrast media in breast imaging. Magn Reson Imaging Clin N Am 2012;20(4):777-89.
• Olsen ML, Morton MJ, Stan DL. Pruthi S. Is there a role for magnetic resonance imaging in diagnosis palpable breast masses when mammogram and ul- trasound are negative? Journal of Women Health 2012;21(11):1149-54.
• Berg WA, Gutierrez L, NessAiver MS, et al. Diagnos- tic accuracy of mammography, clinical examination, and MR imaging in preoperative assessment of breast cancer. Radiology 2004;233(3):830-49.
• Kulkarni S, Singh H, Crystal P. Preoperative breast magnetic resonance imaging; applications in clinical practice. Can Assoc Radiol J 2012;63(3):207-14.
• Orguc S, Basara I, Coskun T. Diffusion-weighted MR imaging of the breast: comparison of apparent diffusion coefficient values of normal breast tissue with benign and malignant breast lesions. Singapore Med J 2012;53(11):737-43.
• Evans DG, Lennard F, Pointon LJ, et al.; UK Study of MRI Screening for breast cancer in women at high risk (MARIBS).Eligibility for magnetic resonance imag- ing screening in the United Kingdom: effect of strict selection criteria and anonymous DNA testing on breast cancer incidence in the MARIBS Study. Cancer Epidemiol Biomarkers Prev 2009;18(7):2123-31.
• Heil J, Czink E, Schipp A, Sohn C, Junkermann H, Golatta M. Detected, yet not diagnosed-breast cancer screening with MRI Mammography in high risk wom- en. Breast Care 2012;7(3):236-9.
• Trecata G, Vergnaghi D, Manoukian S, et al. MRI in the early detection of breast cancer in women with high genetic risk. Tumori 2006;92(6):517-23.
• Londero V, Bazzocchi M, Frate CD, Puglisi F, Lore- to CD, Zuinani G. Locally advenced breast cancer: comparison of mammography, sonography and MR imaging in evaluation of residual disease in woman receiving neoadjuvant chemoterapy. Eur Radiol 2004;14(8):1371-9.
• Goethem MV, Schelfout K, Dijkmans L, et al. MR mammography in the pre-operative staging of breast canser in patients with dense breast tissue: compari- son with mammography and ultrasonud. Eur Radiol 2004;14(5):809-16.
• Wiberg KM, Apselin P, Sylvan M, Bone B. Compar- ison of lesion size estimated by dynamic MR imaging, mammography and histopathology in breast neo- plasms . Eur Radiol 2003;13(6):1207–12.
• Kriege M, Brekelmans CTM, Obdeijn IM, et al. Factors affecting sensitivity and specifity of screening mammography and MRI in women with an inherited risk for breast cancer. Breast Cancer Res Treat 2006;100(1):109–19.
• Duygulu G, Oktay A, Bilgen IG, Kapkaç M, Zekioğlu O. The role of breast MRI in planning the surgical treatment of breast cancer. Diagn Interv Radiol 2012;18(5):460-7.
• Wasif N, Garreu J, Alicia T, Kirsch D, Mund DF, Giuliano AE. MR versus ultrasonography and mam- mography for preoperative assesment of breast canser. Am Surg 2009;75(10):970-5.
• Michael M, Garzoli E, Reiner CS. Mammography, sonography and MRI for detection and characteriza- tion of invasive lobular carsinoma of the breast. Breast Dis 2009;30:21-30.
• Lee J M, Halpem EF, Rafferty EA, Gazelle GS. Eval- uating the correlation between film mammography and MRI for screening woman with increased breast canser risk. Acad Radiol 2009;16(11):1323-8.
• Graneder EJ, Dwar mena B, Carlos RC. MRI and mammography surveillance of women at increased risk for breast canser: recommendation using an evidence-based 2008;15(12):1590-5. Acad Radiol
• Lord SJ, Lei W, Craft P, et al. A systematic review of the effectiveness of magnetic resonance imaging (MRI) as an addition to mammography and ultra- sound in screening young at high risk of breast canser. Eur Journal of Cancer 2007;43(13):1905-17.
• Renz DM, Baltzer PA, Böttcher J, et al. Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study. Eur Radiol 2008;18(11):2370-80.