Abstract
614 Background: An analysis of preoperative bilateral breast MRI at our institution suggests that approximately 1/3 of patients with newly diagnosed breast cancer may have a mammographically occult, but MRI-evident, contralateral breast abnormality. A number of these patients will have pathologic confirmation of carcinoma in the contralateral breast. Identification of risk factors to predict which patients are at high risk for having a mammographically occult contralateral carcinoma was performed. Methods: MRI results of 401 women with newly diagnosed breast carcinoma who underwent MRI were reviewed (overall group; OG). Patients with a contralateral abnormality identified only by MRI were analyzed to determine the incidence of contralateral carcinoma. In addition, the following risk factors were evaluated: Age at diagnosis, menopausal status, tumor size, nodal status, ipsilateral tumor histology, tumor grade, hormone receptor status, Her-2/neu receptor status, and whether the patient had a palpable vs. mammographically detected abnormality. Results: Pathologically confirmed contralateral carcinoma (CC) was found in 13 patients (3.2%). Similar percentages of patients in both groups (OG and CC) were noted in regard to tumor size, histology, grade, nodal status, Her-2/neu receptor status, and method of detection (palpable vs. mammographic). However, median patient age was 71 (CC) vs. 62(OG); 92% (12/13) were postmenopausal (CC) compared to 75% (OG); and 100% were ER positive (CC) vs. 81% percent (OG). Conclusions: Older, postmenopausal women who have ER + tumors may have a higher likelihood of having synchronous, contralateral, mammographically occult, MRI-detected breast carcinoma. Preoperative MRI may be beneficial in patients with similar risk factors; however, further follow up and additional experience is needed for confirmation of these findings. No significant financial relationships to disclose.
Published Version
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