Korean Journal of Radiology

  • 제22권6호
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  • Pages.867-879
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  • 2021
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Detection of Contralateral Breast Cancer Using Diffusion-Weighted Magnetic Resonance Imaging in Women with Newly Diagnosed Breast Cancer: Comparison with Combined Mammography and Whole-Breast Ultrasound

  • Su Min Ha (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Jung Min Chang (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Su Hyun Lee (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Eun Sil Kim (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Soo-Yeon Kim (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Yeon Soo Kim (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Nariya Cho (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Woo Kyung Moon (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital)
  • 투고 : 2020.09.29
  • 심사 : 2020.12.27
  • 발행 : 2021.06.01
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초록

Objective: To compare the screening performance of diffusion-weighted (DW) MRI and combined mammography and ultrasound (US) in detecting clinically occult contralateral breast cancer in women with newly diagnosed breast cancer. Materials and Methods: Between January 2017 and July 2018, 1148 women (mean age ± standard deviation, 53.2 ± 10.8 years) with unilateral breast cancer and no clinical abnormalities in the contralateral breast underwent 3T MRI, digital mammography, and radiologist-performed whole-breast US. In this retrospective study, three radiologists independently and blindly reviewed all DW MR images (b = 1000 s/mm2 and apparent diffusion coefficient map) of the contralateral breast and assigned a Breast Imaging Reporting and Data System category. For combined mammography and US evaluation, prospectively assessed results were used. Using histopathology or 1-year follow-up as the reference standard, cancer detection rate and the patient percentage with cancers detected among all women recommended for tissue diagnosis (positive predictive value; PPV2) were compared. Results: Of the 30 cases of clinically occult contralateral cancers (13 invasive and 17 ductal carcinoma in situ [DCIS]), DW MRI detected 23 (76.7%) cases (11 invasive and 12 DCIS), whereas combined mammography and US detected 12 (40.0%, five invasive and seven DCIS) cases. All cancers detected by combined mammography and US, except two DCIS cases, were detected by DW MRI. The cancer detection rate of DW MRI (2.0%; 95% confidence interval [CI]: 1.3%, 3.0%) was higher than that of combined mammography and US (1.0%; 95% CI: 0.5%, 1.8%; p = 0.009). DW MRI showed higher PPV2 (42.1%; 95% CI: 26.3%, 59.2%) than combined mammography and US (18.5%; 95% CI: 9.9%, 30.0%; p = 0.001). Conclusion: In women with newly diagnosed breast cancer, DW MRI detected significantly more contralateral breast cancers with fewer biopsy recommendations than combined mammography and US.

키워드

과제정보

We thank a Min-ju Kim, a statistician who helped with statistics, Department of clinical epidemiology and biostatistics, Asan Medical Center.

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