COMPARISON OF MAGNETIC-RESONANCE-IMAGING AND CONVENTIONAL TRIPLE ASSESSMENT IN LOCALLY RECURRENT BREAST-CANCER

Background Magnetic resonance imaging (MRI) was compared with triple a ssessment (clinical examination, cytology and mammography) in the diff erentiation of post treatment changes from local recurrence of breast carcinoma. Methods Thirty patients treated previously by breast conser vation surgery and radiotherapy with clinical suspicion of local recur rence were evaluated prospectively by triple assessment and MRI. Breas t MRI was performed on a l-tesla scanner using a T1-weighted three-dim ensional fast low angle shot pulse sequence before and after contrast enhancement. Results Local recurrence was confirmed histologically in 14 patients. Of these, mammography identified seven (sensitivity 50 pe r cent), cytology 11 (sensitivity 79 per cent) and breast MRI 13 (sens itivity 93 per cent). Compared with histological measurement, breast M RI allowed an accurate estimation of the extent of local recurrence (r (2) = 0.98). Morphologically abnormal areas without contrast enhanceme nt correlated with postradiation changes. False-positive contrast enha ncement was seen in two patients (specificity 88 per cent) in whom his tology confirmed inflammatory changes only. Conclusion Breast MRI is u seful in the evaluation of patients with a high clinical suspicion of local recurrence within the irradiated conserved breast.