BREAST-CANCER - FOLLOW-UP BY MRI

Conventional imaging (CI) for breast cancer includes mammography and u ltrasound. Its limited efficiency is especially manifest for breast ca ncer follow-up after breast-conserving therapy (i.e. exclusive radiati on therapy) and after breast implant. Lack of evidence for definitive diagnosis increases the number of invasive explorations. To improve th e specificity of the diagnosis between recurrence or fibrosis, we desc ribe the interest of new imaging (NI) techniques : post-contrast MRI, and MR angiography (MRA), realized in 1 exam. Between October 1993 and December 1994, 82 patients were eligible for these investigations. Al l patients had an history of conservative breast cancer treatment or b reast implant following mastectomy. In all cases CI was not contributi ve for a precise diagnosis; therefore a biopsy was performed and confi rmed the diagnosis of breast cancer. NI was done before biopsy and com pared results are following. 19 more patients were evaluated for prima ry chemotherapeutic response, including a total of 101 patients. Regar ding the follow-up of prothesis and conservative treatment, the correl ation with histological control was obtained in 95 % with four false d iagnosis due to confusion between retroprothesis relapse and inflammat ion. Histo-radiologic correlation were close to 90 % for the evaluatio n of primary chemotherapeutic response. Studies are ongoing to confirm those preliminary findings. Though expansive, these techniques might be cost-effective if they result in a substantial decrease of unnecess ary surgical invasive procedures.