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.
Bibliographical noteFunding Information:
The research was supported by Abbott Northwestern Hospital
The research was supported by Abbott Northwestern Hospital Foundation, Minneapolis, MN.
© 2018 Wiley Periodicals, Inc.
Copyright 2018 Elsevier B.V., All rights reserved.
- contralateral breast cancer
- magnetic resonance imaging
- preoperative evaluation