Indications for breast magnetic resonance imaging at a referral center for the diagnosis and treatment of breast cancer in Brazil.

Samuel Silva Ferreira,Flavia Maria Rodrigues,Antônio Fernando Braga Ferreira Victor,Adriene Moraes Campos,Patrícia Lima Fernandes,Izabela Machado Pereira,Ivie Braga de Paula

doi:10.1590/0100-3984.2019.0114

Samuel Silva Ferreira, Flavia Maria Rodrigues + Show 5 more

Open Access

https://doi.org/10.1590/0100-3984.2019.0114

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Abstract

ObjectiveTo describe the indications for breast magnetic resonance imaging (MRI) at a referral center for breast cancer in Brazil.Materials and MethodsThis was a retrospective study in which we reviewed the clinical records, including physician requests and patient questionnaires, of women who underwent breast MRI between 2014 and 2018 at a referral center for the diagnosis and treatment of breast cancer in the city of Belo Horizonte, Brazil.ResultsThe most common indication for breast MRI was as a complement to mammography/ultrasonography (in 43.6% of cases), followed by breast cancer staging (in 25.1%), the screening of patients at high risk (in 17.4%), the evaluation of breast implants (in 10.1%), and the evaluation of the response to neoadjuvant chemotherapy (in 3.8%).ConclusionAlthough there is strong evidence supporting the use of breast MRI, mainly for the screening of high-risk patients, the imaging method is underutilized in Brazil.

Highlights

Breast cancer is one of the most common neoplasms in women, second only to nonmelanoma skin cancer
Conclusion: there is strong evidence supporting the use of breast magnetic resonance imaging (MRI), mainly for the screening of high-risk patients, the imaging method is underutilized in Brazil
If the indication for breast MRI was unclear, we searched for information in the questionnaires to understand the intent of the physician request and included the indication in one of the subgroups previously described

Summary

Introduction

Breast cancer is one of the most common neoplasms in women, second only to nonmelanoma skin cancer. Ultrasound is not included as a screening method for breast cancer in most international guidelines, being considered a complementary imaging method, especially in women at high risk and in those with dense breasts, as well as a diagnostic evaluation tool in patients under 40 years of age. Magnetic resonance imaging (MRI) has been utilized to detect breast cancer for more than 25 years. It presents higher sensitivity than does mammography, with a detection rate of over 90%, its specificity is variable, ranging from 30% to 90%(3). In the evaluation of the in situ component, MRI presents higher sensitivity than do mammography and ultrasound, with advantages in the diagnosis of lesions in which the nuclear grade of the cancer cells

Results

Discussion

Conclusion