Predictive value of breast magnetic resonance imaging in detecting mammographically occult contralateral breast cancer: Can we target women more likely to have contralateral breast cancer?

Barbara Susnik, Lisa Schneider, Karen K. Swenson, Janet Krueger, Christina Braatz, Tamera Lillemoe, Michaela Tsai, Todd E. DeFor, Monica Knaack, Natasha Rueth

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objectives: Preoperative breast magnetic resonance imaging (B-MRI) staging in newly diagnosed breast cancer increases detection of synchronous contralateral findings, but may result in false-positive outcomes. This study objective was to identify women more likely of having mammographically occult, MRI detected contralateral breast cancer (CBC). Methods: We performed a retrospective review of patients who had preoperative B-MRI prior to surgery from 2010 to 2015 and collected patient imaging and clinicopathologic data. Multivariate logistic regression was used to identify predictors of CBC. Results: MRI resulted in contralateral findings in 201 of 1894 patients (10.6%). Overall 3.2% (60 of 1894) had synchronous CBC detected on B-MRI. The majority of CBCs (n = 60) were stage 0 or IA (85.0%), hormone receptor positive (94.9%), human epidermal growth factor receptor 2 (HER2/neu) negative (89.7%), and low/intermediate pathological grade (87.2%). Women more likely to have CBC were older (P <.001), had lobular index cancer (P =.03), and estrogen receptor (ER)+ (P =.027) or progesterone receptor (PR)+ (P =.002) tumors. On multivariate analysis (receiver operating characteristic curve area = 0.75), PR + status (P =.022), and older age (P =.004) were predictive of CBC. Conclusions: Preoperative MRI is most effective in detecting early stage, hormone receptor-positive CBC in older women.

Original languageEnglish (US)
Pages (from-to)221-227
Number of pages7
JournalJournal of Surgical Oncology
Volume118
Issue number1
DOIs
StatePublished - Jul 1 2018

Bibliographical note

Funding Information:
The research was supported by Abbott Northwestern Hospital

Funding Information:
The research was supported by Abbott Northwestern Hospital Foundation, Minneapolis, MN.

Publisher Copyright:
© 2018 Wiley Periodicals, Inc.

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

  • contralateral breast cancer
  • magnetic resonance imaging
  • predictors
  • preoperative evaluation

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