ROUTINE SCREENING FOR LOCAL RECURRENCE FOLLOWING BREAST-CONSERVING THERAPY FOR CANCER WITH DYNAMIC CONTRAST-ENHANCED MAGNETIC-RESONANCE-IMAGING OF THE BREAST

Background: Dynamic contrast-enhanced magnetic resonance imaging (MRI) of the breast is highly sensitive for the diagnosis of primary boast malignancy. We investigated the clinical application of dedicated dyna mic boast MR for routine screening for local recurrence following brea st-conserving therapy. Methods: Patients underwent a single dynamic MR of the breast routinely in the period 1 to 2 years following treatmen t, or earlier if recurrence was suspected. A biopsy was performed if t here was suspicion of recurrence on MR. Results: One hundred and five patients with a median age of 58 years (range 50 to 65 years) were rec ruited for the study. Sixteen biopsies were performed and nine recurre nces were confirmed histologically. Patients not undergoing biopsy hav e been followed up for a median of 341 days (range 168 to 451 days) fo llowing the MR. The sensitivity for clinical examination, mammography, examination combined with mammography, and MRI alone for the detectio n of recurrent cancer were 89%, 67%, 100%, and 100%, respectively, and the specificity was 76%, 85%, 67%, and 93%. Conclusion: Combined clin ical examination and mammography are as sensitive as dedicated dynamic MR of the breast for the detection of locoregional recurrence, but br east MRI is associated with a far greater specificity. Therefore, dedi cated dynamic breast MRI should be used when there is clinical or mamm ographic suspicion of recurrence to confirm or refute its presence.