Abstract
BackgroundEarly detection of locally recurrent breast carcinoma has been shown to significantly improve long-term survival. Surgery and radiation therapy made treated breast prone to several modifications. This can complicate the interpretation of ultrasound and mammographic images, especially when local recurrence is suspected. The aim of this work is to assess the role of unenhanced MRI (T1WI, T2WI, STIR, and DWI) in differentiating recurrent breast cancer from benign post-operative lesions.ResultsThe presence of fat SI within the lesions had 100% sensitivity, 90.9% specificity, 94.1% PPV, 100% NPV, and 96.2% accuracy in differentiating fat necrosis from recurrent breast carcinoma. A cutoff ADC value of 1 × 10–3 mm2/s for observer one had 80% sensitivity, 90.9% specificity, and 88.9% accuracy in diagnosis of recurrent breast carcinoma. For observer two, a cutoff ADC value of 1.25 × 10–3 mm2/s had sensitivity of 80%, specificity of 88.6%, and diagnostic accuracy of 87.03% in differentiating recurrent breast carcinoma from benign post-operative changes. Unenhanced MRI had 81.8% sensitivity, 97.7% specificity, 90% PPV, 95.5% NPV, and 94.5% accuracy in the diagnosis of recurrent breast carcinoma.ConclusionUnenhanced MRI including T1WI, T2WI, STIR, DWI, and ADC map had high sensitivity, specificity, and diagnostic accuracy in diagnosis of recurrent breast carcinoma and differentiating it from benign post-operative changes.
Highlights
Detection of locally recurrent breast carcinoma has been shown to significantly improve longterm survival
We depended on the analysis of signal intensity of lesions on non-contrast images and the measured apparent diffusion coefficient (ADC) values to differentiate between benign postoperative changes and recurrent breast carcinoma
Regarding the presence of fat signal intensity within the lesions, both observers found that fat Signal intensity (SI) was found in all cases of fat necrosis included in this study and in only two cases of recurrent breast carcinoma included in this study
Summary
Detection of locally recurrent breast carcinoma has been shown to significantly improve longterm survival. Surgery and radiation therapy made treated breast prone to several modifications This can complicate the interpretation of ultrasound and mammographic images, especially when local recurrence is suspected. The incidence of ipsilateral recurrent breast carcinoma is about 1% per year for invasive breast cancer and is slightly less for ductal carcinoma in situ (DCIS). Detection of locally recurrent breast carcinoma has been shown to significantly improve long-term survival [2]. This can complicate the Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been shown to be a valuable tool in detection and characterization of primary and recurrent breast carcinoma [4]. DCE-MRI has been shown to be useful in differentiating post-operative scar from recurrent breast carcinoma, whereas non-enhancing lesions usually represent postoperative scar rather than recurrent breast carcinoma [5]
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