Follow-up screening with Magnetic Resonance Imaging MRI Breast Cancer
Multifocality and Multicentricity
If specialists find a significant lesion on an initial mammogram, an MRI is often useful to check for multifocality (more than one mass on the same breast) and multicentricity (presense of a mass or lesion on the contralateral breast).
MRI is routinely done as a preoperative staging procedure. Multifocal and multicentric tumors are succesfully detected through magnetic resonance imaging about 80% of the time.
By comparison, a mammogram reveals multifocal and multicentric tumors about 45% of the time, with supplementary ultrasound increasing the sensibility to approximately 63%.
This page still has some great material, and I would still use it. However, I have a newer version with more up-to-date information on MRI screening.
Follow-up of biopsy
Frequently doctors will follow-up a suspicious finding on mammograph with an appropriate biopsy.
If a patient is in the ‘high risk’ due to the discovery of lobular neoplasia or some other atypical celluar appearance, MRI may be useful to reinforce a preliminary diagnosis.
Often a patient will present with a negative finding on a mammograph but a positive finding of axillary lymph node metastasis from biopsy samples from that region.
In these cases MRI is used in a kind of ‘reverse‘ investigation to discover the ‘primary‘ tumor in the breast. The success rate for finding these ‘occult‘ primary tumors in this manner is about 75%.
Post Operative use of MRI Breast Cancer
Following surgical treatments, medics will frequently use MRI to check for residual tumors. The physician will often perform the MRI scan within nine days of the initial surgery, but the most accurate readings occur after approximately 38 to 40 days.
One of the challenges in the follow-up of lumpectomy, with or without radiation treatment, is that specialists can often confuse tumors with predictable scar tissue development.
A lumpectomy scar may contain vascularised granulation tissue up to 18 months following surgery. So there is a limited ‘window‘ for accurate MRI investigations during this period.
To avoid this potential confusion, best results occur no later than 5 weeks following the surgery. The success rate of MRI in differentiating scar from tumor recurrence is very high, 90% or more.
Granulated scar tissue tends to be more regular and homogeneous around the surgery site, while cancerous cells tend to divide and spread in a somewhat random fashion. The use of post operative, follow-up MRI has been shown to ‘alter‘ the original breast cancer treatment plans in up to 30% of cases.
Magnetic Resonance imaging following chemotherapy
The usefulnes of magnetic resonance imaging following chemotherapy remains unclear. There is consensus that MRI is useful for monitoring a patient’s response to ongoing chemical therapy.
By visually checking on the progress of the tumor, adjustments can be made to the drug regimen and the optimal timetable for surgical removal can be planned. A magnetic resonance image can clearly indicate the complete failure of the tumors response to chemotherapy if no change is evident.
What MRI can not definitively determine is whether or not there remains some microscopic residual disease at the end of a course of chemotherapy. Histological cellular analysis is the only method that can determine the complete absence of carcinoma.
For further reading, I suggest you visit this page with information about MRI factors, visit this page to read about MRI for breast cancer staging, and visit this page to know about typical uses for MRI in breast cancer screening and diagnosis. They all have fun Q&A quizzes for you as well!
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