[Whole-body MRI in preoperative diagnostics of breast cancer—a comparison with [corrected] staging methods according to the S 3 guidelines]

D Hausmann, C Kern, M T Schröder, M Sütterlin, S O Schönberg, K W Neff, D J Dinter
RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin 2011, 183 (12): 1130-7

PURPOSE: The German Society of Senology (step-3 guidelines for the early recognition of breast cancer in Germany) recommends whole-body staging including chest X-ray, ultrasound of the liver and bone scintigraphy before systemic therapy in patients with breast cancer. The performance of these three examinations is time-consuming and involves radiation exposure. Whole-body MR imaging (WB-MRI) allows staging in a single examination without radiation exposure. The purpose of this study was to compare the diagnostic accuracy of WB-MRI with staging according to the guidelines.

MATERIALS AND METHODS: During 04/07 and 06/09, the initial staging in 51 patients (56 ± 12 yrs) with breast cancer (24 patients with lymph node metastases) was performed according to the S 3-guidelines. Additionally, all patients underwent contrast-enhanced WB-MRI (1.5-Tesla-Magnetom Avanto, Siemens, Erlangen). The findings of the different modalities were compared after correlation of the lesions by follow-up. The detection of suspicious findings and the accuracy of prediction of malignancy of the detected lesions were evaluated.

RESULTS: Overall, 14 metastases were detected in 4 of 51 patients after completion of the follow-up. By means of WB-MRI, all 14 metastases could be detected, while just 4 of these metastases were identified by the conventional methods.

CONCLUSION: The detection of distant metastases has an important impact on patient management. In this study WB-MRI in breast cancer staging has shown promising results in regard to possible clinical implementation as a matter of routine staging.

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