News | MRI Breast | January 15, 2021

New Suspicious Lesions on Breast MRI in Neoadjuvant Therapy

New suspicious findings occurred in 5.5% of breast MRI examinations performed to monitor response to neoadjuvant therapy; none of these new lesions were malignant

A, Contrast-enhanced axial T1-weighted fat-saturated image from baseline MRI before initiation of neoadjuvant therapy shows irregular mass (arrow) in upper inner right breast corresponding to biopsy-proven carcinoma. B, Contrast-enhanced axial T1-weighted fat-saturated image from follow-up MRI performed 3 months after initiation of neoadjuvant therapy shows decrease in size of right breast cancer (arrow). C, Contrast-enhanced axial T1-weighted fat-saturated image 3 months after initiation of neoadjuvant the

A, Contrast-enhanced axial T1-weighted fat-saturated image from baseline MRI before initiation of neoadjuvant therapy shows irregular mass (arrow) in upper inner right breast corresponding to biopsy-proven carcinoma. B, Contrast-enhanced axial T1-weighted fat-saturated image from follow-up MRI performed 3 months after initiation of neoadjuvant therapy shows decrease in size of right breast cancer (arrow). C, Contrast-enhanced axial T1-weighted fat-saturated image 3 months after initiation of neoadjuvant therapy shows new mass (arrow) in upper outer left breast that was assessed as BI-RADS 4. Pathologic examination from MRI-guided core biopsy of new suspicious mass revealed benign usual ductal hyperplasia. No atypia or malignancy was identified. Image courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

January 15, 2021 — According to ARRS' American Journal of Roentgenology (AJR), new suspicious findings occurred in 5.5% of breast MRI examinations performed to monitor response to neoadjuvant therapy; none of these new lesions were malignant.

"Our findings suggest that new lesions that arise in the setting of neoadjuvant therapy are highly unlikely to represent a new site of malignancy, particularly if the index malignancy shows treatment response," wrote Donna A. Eckstein and colleagues in the department of radiology and biomedical imaging at the University of California, San Francisco.

Based on a presentation at the ARRS 2019 Annual Meeting, Honolulu, HI, the researchers' retrospective review pinpointed all breast MRI examinations performed to assess response to neoadjuvant therapy between 2010 and 2018. Cases with new suspicious lesions assessed as BI-RADS 4 or 5 and found after the initiation of neoadjuvant treatment were included. Meanwhile, exclusion criteria were cases with no pretreatment MRI, cases in which the suspicious lesion was present on the baseline MRI but remained suspicious, and cases with insufficient follow-up. Pathologic examination determined malignant outcomes, whereas benignity was established by pathologic examination, follow-up imaging, or both.

A total of 419 breast MRI examinations in 297 women (mean patient age, 45 years; range, 32-65 years) were performed to assess response to neoadjuvant treatment. After exclusions, 23 MRI examinations (5.5%) with new suspicious findings distinct from the site of known malignancy comprised the final study cohort. Of these 23 lesions, 13 new suspicious findings (56.5%) were contralateral to the known malignancy, nine (39.1%) were ipsilateral, and one (4.3%) involved the bilateral breasts. Lesion types included mass (16, 69.6%), nonmass enhancement (5, 21.7%), and focus (2, 8.7%).

Noting that, currently, there are no guidelines for the management of new suspicious imaging findings identified on MRI during the course of neoadjuvant systemic breast cancer treatment, "results in this small cohort suggest that these new findings are highly likely to be benign, particularly in the setting of response to therapy, which may potentially obviate biopsies in these patients in the future," wrote Eckstein et al.

"However," the authors of this AJR article concluded, "larger studies across different facilities are needed to confirm whether biopsy may be safely averted in this scenario."

For more information: www.arrs.org

Related Content

#SiemensHealthineers #Varian #Siemens The transformative combination accelerates the company’s impact on #global #healthcare and establishes a strong partner for #customers and #patients along the entire #cancer care continuum and for many of the most threatening #diseases
News | Radiology Business | April 15, 2021
April 15, 2021 — Siemens Healthineers AG an
Comparisons of high definition and standard definition infrared imaging for digital histopathology. Image courtesy of the Beckman Institute

Comparisons of high definition and standard definition infrared imaging for digital histopathology. Image courtesy of the Beckman Institute

News | Breast Imaging | April 14, 2021
April 14, 2021 — Detecting and analyzing breast cancer
A 37-year-old woman developed a new, palpable left supraclavicular lymphadenopathy lump five days after her first dose of the Moderna COVID-19 vaccine in the left arm. On the day of vaccination, the patient was asymptomatic. This is an example of how the vaccine can mimic cancer and swollen lymph nodes. Image used with permission of RSNA.

A 37-year-old woman developed a new, palpable left supraclavicular lymphadenopathy lump five days after her first dose of the Moderna COVID-19 vaccine in the left arm. On the day of vaccination, the patient was asymptomatic. This is an example of how the vaccine can mimic cancer and swollen lymph nodes. Read more about this case study. Image used with permission of RSNA.

Feature | Coronavirus (COVID-19) | April 09, 2021 | By Dave Fornell, Editor
While the mass COVID-19 vaccinat
3-D mammography reduces the number of breast cancer cases diagnosed in the period between routine screenings, when compared with traditional mammography, according to a large study from Lund University in Sweden. The results are published in the journal Radiology.

Getty Images

News | Breast Imaging | April 09, 2021
April 9, 2021 — 3-D mammography reduces the number of breast cancer cases diagnosed in the period between routine scr
Mobidiag Oy, a privately held, commercial-stage Finnish-French developer of innovative molecular diagnostic tests and instrumentation, announced today that it has signed a definitive agreement to be acquired by Hologic, Inc., a global leader in women's health, for an enterprise value of approximately $795 million.  This includes a cash payment of approximately $714 million for Mobidiag’s equity, and net debt of approximately $81 million.
News | Women's Health | April 08, 2021
April 8, 2021 — Mobidiag Oy, a privately held, commercial-stage F
Ultrasound is an invaluable diagnostic tool for the early detection of breast cancer, but the classification of lesions is sometimes challenging and time consuming. Could artificial intelligence hold the answer to solving these problems? Graphic courtesy of Chinese Medical Journal

Ultrasound is an invaluable diagnostic tool for the early detection of breast cancer, but the classification of lesions is sometimes challenging and time consuming. Could artificial intelligence hold the answer to solving these problems? Graphic courtesy of Chinese Medical Journal

News | Artificial Intelligence | April 06, 2021
April 6, 2021 — In 2020, the International Agency for Research on...
While the COVID-19 crisis is challenging, the pandemic is also giving researchers an opportunity to discover new approaches to saving lives. A study published in the JAMA Network Open on Thursday, March 25, 2021, recommends a new way for triaging mammogram patients during times of limited capacity, such as pandemic surges, when individuals may also experience anxiety about COVID-19.

Getty Images

News | Breast Imaging | April 01, 2021
April 1, 2021 — While the COVID-19 crisis is challenging, the pandemic is also giving researchers an opportunity to d
In looking at the broader impact of the COVID-19 pandemic on health and wellbeing, public health experts are examining screening rates for cancer. A new study looking at U.S. mammography screening rates during the first five months of the pandemic found both a strong rebound in breast cancer screening rates and a concerning cumulative deficit in mammograms due to missed appointments, as well as uncovering disparities when looking at screening according to race

Getty Images

News | Breast Imaging | April 01, 2021
April 1, 2021 — In looking at the broader impact of the...