SENA ÜNAL, EBRU DÜŞÜNCELİ ATMAN, ELİF PEKER, İLHAN ERDEN, UMMAN SANLIDİLEK
Ankara Üniversitesi Tıp Fakültesi Mecmuası - 2023;76(4):297-303
Objectives: To compare magnetic resonance imaging (MRI) findings with postoperative pathological results and to show the effects of MRI on surgical procedures. Materials and Methods: In this study 31 breast cancer patients whose diagnosis had been proven histopatologically and examined with breast MRI were evaluated retrospectively. The size of the tumor, additional foci in the same breast, the existence of tumor in the other breast, extension to the chest wall and axillary lymph node metastasis were noted. These findings were compared with postoperative histopathological findings. Results: In 10 patients multifocal disease was identified but only in 3 patients it was proven pathologically. In 1 patient MRI could not identify the additional foci [sensitivity 66%, specificity 71%, positive predictive value (PPV) 20%, negative predictive value (NPV) 95%]. In 2 patients MRI found multicentric foci and they were confirmed with pathology. Out of 6 patients with suspicious findings in the contralateral breast, 1 patient was diagnosed as cancer (sensitivity 100%, specificity 83%, PPV 17%, NPV 100%). Thirteen patients were evaluated as positive for axillary lymph node involvement. One of them did not have axillary lymph node metastasis in the pathology specimens. In 1 patient MRI could not identify the axillary lymph node metastasis (sensitivity 92%, specificity 94%, PPV 92%, NPV 94%). Compared to histopathological measurements, we obtained a high reliability ratio (88%) for the lesion sizes. Conclusion: MRI can be used to exclude additional foci in patients who have high risks for multifocal and contralateral disease. MRI may reveal false positive results and therefore the diagnosis must be proven with pathology before surgery.
