MRI in detecting breast cancer recurrence seems be necessary

Early detection and diagnosis of breast cancer are essential for successful treatment. Currently mammography and ultrasound are the basic imaging techniques for the detection and localization of breast tumors. The low sensitivity and specificity of these imaging tools resulted in a demand for new imaging modalities and breast magnetic resonance imaging (MRI) has become increasingly important in the detection and delineation of breast cancer in daily practice. Contrast enhanced magnetic resonance imaging (CE-MRI) with its high soft tissue contrast, multiplanar sectioning and three dimensional representation of the breast provides high sensitivity (over 90%) in the detection of breast cancer. Remarkable advances in MRI technology have allowed sensitive detection and anatomic definition of cancer and the introduction of MRI in several aspects of breast cancer diagnosis and management. Diagnosis of breast cancer recurrence can be difficult as a result of the presence of scar tissue in the breast. Magnetic resonance imaging (MRI) may be superior to traditional imaging in diagnosis of recurrence because of its ability to differentiate malignancy from scarring. Current guidelines on investigation of suspected breast cancer recurrence recommend MRI when other investigations have equivocal findings. Literature search revealed 35 potentially relevant studies; 10 were included in final analysis. Included were clinical studies comparing MRI with another diagnostic modality for diagnosis of breast cancer recurrence, with at least 10 patients, in the English language. Data extraction focused on sensitivity and specificity of standard diagnostic modalities and MRI for diagnosis of local disease recurrence. Available data are based on clinically heterogeneous case series and superiority over standard triple assessment for breast cancer recurrence has not been proven. At present, MRI cannot be recommended in the routine diagnostic assessment for breast cancer recurrence but has a potentially useful role as a second-line investigation. A negative MRI is more useful than a positive MRI as positive MRIs require further investigation .Dynamic MRI appears a valuable technique for differentiation of post-treatment changes from recurrent carcinoma and for guiding the histological confirmation. Its high negative predictive value may have an impact on follow-up of treated breast.

Keywords:

MRI , Breast Cancer , Recurrenceearly Diagnosismagnetic