Nipple-centered Radiate MPR Images of MDCT for Evaluation of Breast Cancer Extent Correlation with Mammography and Pathologic Specimen

Background & Aims : Evaluation of the extent of breast cancer lesions is important for selecting the appropriate surgical procedure or to determine the surgical margin. We aimed to assess the diagnostic accuracy of nipple-centered radiate multiplanar reconstruction (NRMPR) images using multidete...

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Published inThe Kitakanto Medical Journal Vol. 59; no. 2; pp. 123 - 129
Main Authors Kunimatsu, Natsuko, Kunimatsu, Akira, Akahane, Masaaki, Morooka, Miyako
Format Journal Article
LanguageEnglish
Published The Kitakanto Medical Society 01.05.2009
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ISSN1343-2826
1881-1191
DOI10.2974/kmj.59.123

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Abstract Background & Aims : Evaluation of the extent of breast cancer lesions is important for selecting the appropriate surgical procedure or to determine the surgical margin. We aimed to assess the diagnostic accuracy of nipple-centered radiate multiplanar reconstruction (NRMPR) images using multidetector row helical computed tomography (MDCT), comparing it with conventional mammography. Methods : Our subjects were 26 breast cancer patients with a total of 29 lesions who sequentially received contrast-enhanced MDCT imaging for preoperative evaluation. We measured the maximum diameter of the breast cancer in the direction toward the nipple on NRMPR images and mammography. All data were correlated with histopathological mapping of the specimens. Results : The tumor extent measured on NRMPR images and in pathological examinations ranged from 12.4 to 66.0mm (average, 28.0mm) and 10 to 70mm (average, 27.9mm), respectively. The correlation coefficient of the two measurements was 0.898. On mammography, two lesions were not clearly identified. The correlation coefficient of mammography and pathological measurements was 0.554. Conclusions : The addition of NRMPR images to mammography provides more information to evaluate breast cancer extension toward the nipple. Potentially, it provides a clue for selecting the appropriate surgical procedure or surgical resection margin for breast cancer.
AbstractList Background & Aims : Evaluation of the extent of breast cancer lesions is important for selecting the appropriate surgical procedure or to determine the surgical margin. We aimed to assess the diagnostic accuracy of nipple-centered radiate multiplanar reconstruction (NRMPR) images using multidetector row helical computed tomography (MDCT), comparing it with conventional mammography. Methods : Our subjects were 26 breast cancer patients with a total of 29 lesions who sequentially received contrast-enhanced MDCT imaging for preoperative evaluation. We measured the maximum diameter of the breast cancer in the direction toward the nipple on NRMPR images and mammography. All data were correlated with histopathological mapping of the specimens. Results : The tumor extent measured on NRMPR images and in pathological examinations ranged from 12.4 to 66.0mm (average, 28.0mm) and 10 to 70mm (average, 27.9mm), respectively. The correlation coefficient of the two measurements was 0.898. On mammography, two lesions were not clearly identified. The correlation coefficient of mammography and pathological measurements was 0.554. Conclusions : The addition of NRMPR images to mammography provides more information to evaluate breast cancer extension toward the nipple. Potentially, it provides a clue for selecting the appropriate surgical procedure or surgical resection margin for breast cancer.
Author Morooka, Miyako
Akahane, Masaaki
Kunimatsu, Akira
Kunimatsu, Natsuko
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  fullname: Akahane, Masaaki
  organization: Department of Radiology, International Medical Center of Japan
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  fullname: Morooka, Miyako
  organization: Department of Radiology, International Medical Center of Japan
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9. Inoue T, Tamaki Y, Hamada S, et al. Usefulness of three-dimensional multidetector-row CT images for preoperative evaluation of tumor extension in primary breast cancer patients. Breast Cancer Res Treat 2005 ; 89 : 119-125.
6. Uematsu T, Sano M, Homma K. False-positive helical CT findings of multifocal and multicentric breast cancer : is attenuation of tumor useful for diagnosing enhanced lesions? Breast Cancer 2002 ; 9 : 62-68.
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4. Uematsu TS, M. Homma, K. Shiina, M. et al. Three-dimensional helical CT of the breast : Accuracy for measuring extent of breast cancer candidates for breast conserving surgery. Breast Cancer Research and Treatment 2001 ; 65 : 249-257.
17. Kuwada T, Tozaki M, Harada J. Evaluation of enhancement patterns using three-dimensional dynamic contrast-enhanced MR imaging in 209 cases of breast cancer. Nippon Igaku Hoshasen Gakkai Zasshi 2004 ; 64 : 544-551.
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18. Ozaki S, Tozaki M, Fukuma E, et al. Bilateral breast MR imaging : is it superior to conventional methods for the detection of contralateral breast cancer? Breast Cancer 2008 ; 15 : 169-174.
3. Takase K, Furuta A, Harada N, et al. Assessing the extent of breast cancer using multidetector row helical computed tomography. J Comput Assist Tomogr 2006 ; 30 : 479-485.
5. Akashi-Tanaka S, Fukutomi T, Miyakawa K, et al. Contrast-enhanced computed tomography for diagnosing the intraductal component and small invasive foci of breast cancer. Breast Cancer 2001 ; 8 : 10-15.
7. Uematsu T, Sano M, Homma K, et al. Comparison between high-resolution helical CT and pathology in breast examination. Acta Radiol 2002 ; 43 : 385-390.
19. Fischer U, Baum F, Luftner-Nagel S. Preoperative MR imaging in patients with breast cancer : preoperative staging, effects on recurrence rates, and outcome analysis. Magn Reson Imaging Clin N Am 2006 ; 14 : 351-362.
References_xml – reference: 13. Perrone A, Lo Mele L, Sassi S, et al. MDCT of the breast. AJR Am J Roentgenol 2008 ; 190 : 1644-1651.
– reference: 16. Macdonald HR, Silverstein MJ, Lee LA, et al. Margin width as the sole determinant of local recurrence after breast conservation in patients with ductal carcinoma in situ of the breast. Am J Surg 2006 ; 192 : 420-422.
– reference: 19. Fischer U, Baum F, Luftner-Nagel S. Preoperative MR imaging in patients with breast cancer : preoperative staging, effects on recurrence rates, and outcome analysis. Magn Reson Imaging Clin N Am 2006 ; 14 : 351-362.
– reference: 12. Taira N, Ohsumi S, Takabatake D, et al. Contrast-enhanced CT evaluation of clinically and mammographically occult multiple breast tumors in women with unilateral early breast cancer. Jpn J Clin Oncol 2008 ; 38 : 419-425.
– reference: 14. MacDonald HR, Silverstein MJ, Mabry H, et al. Local control in ductal carcinoma in situ treated by excision alone : incremental benefit of larger margins. Am J Surg 2005 ; 190 : 521-525.
– reference: 18. Ozaki S, Tozaki M, Fukuma E, et al. Bilateral breast MR imaging : is it superior to conventional methods for the detection of contralateral breast cancer? Breast Cancer 2008 ; 15 : 169-174.
– reference: 6. Uematsu T, Sano M, Homma K. False-positive helical CT findings of multifocal and multicentric breast cancer : is attenuation of tumor useful for diagnosing enhanced lesions? Breast Cancer 2002 ; 9 : 62-68.
– reference: 1. Kunos C, Latson L, Overmoyer B, et al. Breast conservation surgery achieving>or=2mm tumor-free margins results in decreased local-regional recurrence rates. Breast J 2006 ; 12 : 28-36.
– reference: 8. Doihara H, Fujita T, Takabatake D, et al. Clinical significance of multidetector-row computed tomography in breast surgery. Breast J 2006 ; 12 : S204-209.
– reference: 2. Akashi-Tanaka S, Fukutomi T, Sato N, et al. The role of computed tomography in the selection of breast cancer treatment. Breast Cancer 2003 ; 10 : 198-203.
– reference: 9. Inoue T, Tamaki Y, Hamada S, et al. Usefulness of three-dimensional multidetector-row CT images for preoperative evaluation of tumor extension in primary breast cancer patients. Breast Cancer Res Treat 2005 ; 89 : 119-125.
– reference: 11. Tozaki M. Diagnosis of breast cancer : MDCT versus MRI. Breast Cancer 2008 ; 15 : 205-211.
– reference: 17. Kuwada T, Tozaki M, Harada J. Evaluation of enhancement patterns using three-dimensional dynamic contrast-enhanced MR imaging in 209 cases of breast cancer. Nippon Igaku Hoshasen Gakkai Zasshi 2004 ; 64 : 544-551.
– reference: 7. Uematsu T, Sano M, Homma K, et al. Comparison between high-resolution helical CT and pathology in breast examination. Acta Radiol 2002 ; 43 : 385-390.
– reference: 10. Uematsu T, Yuen S, Kasami M, et al. Comparison of magnetic resonance imaging, multidetector row computed tomography, ultrasonography, and mammography for tumor extension of breast cancer. Breast Cancer Res Treat 2008.
– reference: 3. Takase K, Furuta A, Harada N, et al. Assessing the extent of breast cancer using multidetector row helical computed tomography. J Comput Assist Tomogr 2006 ; 30 : 479-485.
– reference: 15. Cabioglu N, Hunt KK, Buchholz TA, et al. Improving local control with breast-conserving therapy : a 27-year single-institution experience. Cancer 2005 ; 104 : 20-29.
– reference: 4. Uematsu TS, M. Homma, K. Shiina, M. et al. Three-dimensional helical CT of the breast : Accuracy for measuring extent of breast cancer candidates for breast conserving surgery. Breast Cancer Research and Treatment 2001 ; 65 : 249-257.
– reference: 5. Akashi-Tanaka S, Fukutomi T, Miyakawa K, et al. Contrast-enhanced computed tomography for diagnosing the intraductal component and small invasive foci of breast cancer. Breast Cancer 2001 ; 8 : 10-15.
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Snippet Background & Aims : Evaluation of the extent of breast cancer lesions is important for selecting the appropriate surgical procedure or to determine the...
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StartPage 123
SubjectTerms breast cancer
mammography
multidetector row helical CT
tumor extent
Subtitle Correlation with Mammography and Pathologic Specimen
Title Nipple-centered Radiate MPR Images of MDCT for Evaluation of Breast Cancer Extent
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