Abstract
Background: The aim of this study was to demonstrate the feasibility of performing multidetector computed tomography (MDCT) with a dedicated protocol for locoregional staging in breast cancer patients. Methods: This prospective single-center study included newly diagnosed breast cancer patients submitted to contrast-enhanced chest MDCT and breast magnetic resonance imaging (MRI). MDCT was performed in prone position and using subtraction techniques. Fleiss’ Kappa coefficient (K) and intraclass correlation coefficient (ICC) were used to assess agreement between MRI, MDCT, and pathology, when available. Results: Thirty-three patients were included (mean age: 47 years). Breast MRI and MDCT showed at least substantial agreement for evaluation of tumor extension (k = 0.674), presence of multifocality (k = 0.669), multicentricity (k = 0.857), nipple invasion (k = 1.000), skin invasion (k = 0.872), and suspicious level I axillary lymph nodes (k = 0.613). MDCT showed higher number of suspicious axillary lymph nodes than MRI, especially on levels II and III. Both methods had similar correlation with tumor size (MRI ICC: 0.807; p = 0.008 vs. MDCT ICC: 0.750; p = 0.020) and T staging (k = 0.699) on pathology. Conclusions: MDCT with dedicated breast protocol is feasible and showed substantial agreement with MRI features in stage II or III breast cancer patients. This method could potentially allow one-step locoregional and systemic staging, reducing costs and improving logistics for these patients.
Highlights
Prognosis of breast cancer depends on the extent of the disease and biological characteristics of the tumor [1]
For a proper evaluation of the breast parenchyma in multidetector computed tomography (MDCT), we proposed to use a dedicated protocol, to be performed in prone position, similar to breast magnetic resonance imaging (MRI), in addition to using subtraction techniques, which allow improvement of the contrast resolution between breast cancer and normal tissues, without significant increase in examination time or radiation dose
Our results showed that MDCT with a dedicated breast protocol can be used for distant and locoregional staging in breast cancer patients
Summary
Prognosis of breast cancer depends on the extent of the disease (staging) and biological characteristics of the tumor [1]. The basic evaluation for locoregional staging of breast cancer patients includes clinical examination, mammography, and ultrasound [2]. Breast magnetic resonance imaging (MRI) has been increasingly used, as it has proven to be superior to conventional imaging methods in assessing tumor extent and identifying additional lesions [3,4]. The aim of this study was to demonstrate the feasibility of performing multidetector computed tomography (MDCT) with a dedicated protocol for locoregional staging in breast cancer patients. Methods: This prospective single-center study included newly diagnosed breast cancer patients submitted to contrast-enhanced chest MDCT and breast magnetic resonance imaging (MRI). Breast MRI and MDCT showed at least substantial agreement for evaluation of tumor extension (k = 0.674), presence of multifocality (k = 0.669), multicentricity (k = 0.857), nipple invasion (k = 1.000), skin invasion (k = 0.872), and suspicious level I axillary lymph nodes (k = 0.613)
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