Comparative analysis of intraductal spread of breast cancer between helical computed tomography and magnetic resonance imaging.

点击翻译按钮获取中文摘要

BACKGROUND. Surgical clearance of all the cells is important to avoid local failure in breast conserving surgery. Various imaging modalities have been applied to predict the carcinoma extension. We have reported that 3-D magnetic resonance imaging (MRI) is more accurate than mammography and ultrasonography in measuring the extent of tumor when precisely assessed with histological measurements. This study was initiated to compare the utility of helical computed tomography (CT) and 3-D MRI in detecting the extension and multicentricity of breast cancer.METHODS. Fifty-two patients with primary breast cancer were subjected to helical CT and MRI, subsequently reconstructed three dimensionally using software before operation. Surgical specimens were subjected to serial slices 5mm thick and mapped pathologically. The sensitivity, specificity and accuracy were investigated for detecting intraductal spread of carcinoma (ISC) and multicentricity of small foci of breast cancer.RESULTS. 1) Seventeen cases with high grade ISC (over 2cm) were observed pathologically. Both CT and MRI were useful for detecting high grade ISC in 11 of 17 cases, whereas neither of them were available in 5 of 17 cases. 2) The sensitivity of MRI for detecting high grade ISC was higher than CT (71% vs 65%). 3) The specificity of CT for detecting multicentricity was higher than MRI (93% VS 80%). 4) Both CT and MRI were more accurate in measuring carcinoma extension when tumor with comedo type of intraductal component and high histological grade (grade III).CONCLUSIONS. The results suggested that 3-D CT tends to underestimate, whereas 3-D MRI is likely to overestimate. Subtype of intraductal component and histological grade were associated with accuracy of measuring carciooma extension due to high vascularity