Multimodality detection of multicentric breast cancer

Abstract

624 Background: It is important to establish the local extent of breast cancer in order to make an informed decision with regard to therapeutic approach. The relative performance of the available breast imaging modalities with respect to the detection of multicentric cancer has not been established. This study is aimed at comparing MRI, Sonography, FSM, DM and FDG-PET in the detection of multicentric disease in a patient with known breast cancer. Methods: Women with a positive biopsy for breast cancer or Birads category5 mammogram were eligible. Imaging included MRI, Ultrasound, Digital mammography and PET. All examinations were interpreted with knowledge of initial Film screen findings, clinical exam findings and any relevant history. Modalities were interpreted by different radiologists initially blinded to other modalities and then a consensus was developed. Birads assessment was assigned to each finding. Results: A total of 86 patients with 87 incidental lesions in the ipsilateral breast were analyzed. 43 incidental lesions (separate from the index cancer) in 35 patients were felt to be suspicious for multicentric cancers on consensus. To date, 26 women underwent biopsy of their incidental lesions which yielded 23 cases of multicentric cancer. Of these 23 cases of multicentric cancer, 14 were identified on MRI, 11 on sonography, 7 on digital mammography and 5 on film screen mammography and 1 on PET. Conclusions: MRI had the highest yield for multicentric cancer followed by Sonography and X-ray mammography. PET has the lowest yield. No significant financial relationships to disclose.