Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
Liesbeth Meylaerts is currently completing her Ph.D. at the University of Hasselt. She is working as a radiologist in Ziekenhuis Oost-Limburg, Genk, Belgium. She has published 11 papers in reputed journals and 1 book chapter.
Although magnetic resonance imaging (MRI) has a high sensitivity in the detection of tumours, there is still a lot of discussion about its role in breast cancer detection. MRI is not routinely used to further characterize lesions in patients diagnosed with breast cancer. In this study, the impact of preoperative MRI on the surgical treatment of women with biopsy proven breast cancer was investigated. The diagnostic value of preoperative MRI was compared with that of mammography and ultrasonography. In addition, the recently developed diffusion weighted imaging technique was evaluated and optimized. 40 women underwent conventional imaging and biopsy as part of the clinical workup. In addition, preoperative MRI was performed in each patient. The kinetics of contrast captation was monitored and apparent diffusion coefficients were calculated. All imaging findings were compared with the histopathologic results, which were used as the gold standard. Differences in tumour extent, as determined by ultrasonography, MRI and histopathology, were evaluated. The results show that contrast captation kinetics curves are mostly aspecific, while apparent diffusion coefficient values seem to correlate much better with tumour malignancy. MRI was found to correlate more accurately with histopathological findings than ultrasonography and mammography, yielding more precise information about the exact location, the extent, the multifocality or multicentricity of the tumour. MRI revealed unsuspected multifocal and multicentric breast carcinoma in twenty patients (50%). The surgical plan of seven patients (18%) was changed as a result of the additional information provided by MRI.