The role of MR mammography in breast-conserving therapy

The role of contrast-enhanced MRI for selecting candidates for breast- conserving therapy was evaluated. Of 87 patients examined, 66 patients had invasive ductal carcinoma, 9 had invasive lobular carcinoma, 4 had mucinous carcinoma, 1 had medullary carcinoma, 2 had ductal carcinoma in situ (DCIS), 2 had DCIS with microinvasion and 3 had Paget's Disease. A 1.5 T Signa imager (GE Medical Systems) was used with a dedicated breast coil. The pulse sequence based on RARE (rapid acquisition with relaxation enhancement) was used with a fat suppression technique. Linear and/or spotty enhancement on MRI was considered to suggest DCIS or intraductal spread. The sensitivity, specificity, and accuracy for detecting intraductal spread on MRI were 91%, 80%, and 80%, respectively. Contrast-enhanced MRI was also considered useful in estimating the extent of intraductal spread and in planning size of excision. However, sometimes fibrocystic disease may mimic intraductal spread, and careful interpretation is necessary.