Abstract

BACKGROUND: Female patients presenting to the OPD of the departments of General Surgery and Radiation Oncology who presented with breast masses, that were either palpable or radiologically documented were included in the study. All the patients were managed as per the set proforma before a contrast MRI of breasts was done on them to see for detection and characterization of breast disease ( type, localization and staging) along with assessment of local extent of the disease, evaluation of treatment response and guidance for biopsy and localization of disease . AIM: To evaluate and study the usefulness of contrast kinetics of various breast lesions using MRI e.g. In differentiating benign from malignant lesions etc,and to study the usefulness of MRI in identifying additional synchronous breast lesions, not otherwise suspected e.g. as in multicentric carcinomas as well as staging of malignant breast lesions. METHODS: We performed a prospective study for a total period of two years which included total of 60 patients from varied age groups, ranging from adolescents to elderly. Female patients with breast masses, where worked up as per the set proforma before the contrast MRI of breasts was done . 1.5-Tesla MRI system with a dedicated four-channel dual breast coilwas used . Chest survey was done with STIR and T1W sequences acquired in an axial plane. Precontrast fat-suppressed T1W gradient-echo images were first obtainedand this was followed by intravenous contrast injection. Gadodiamide (GdDTPA-BMA), 0.1 mmol/kg body weightbolus, using a pressure injector with a flow rate of 2.0 ml/s, followed by a flush of 20 ml of saline was used and dynamic scans were then obtained. All observations where made note ofto see for type, extend and staging of breast diseases in these patients. RESULTS : We inferred that MRI Showing masses with lobulated or irregular shape and spiculations had more chances of being malignant and on the contrary, masses with round or oval shape with smooth margins were more likely to be benign. Also lesions with heterogeneous, rim and central enhancement pattern on MRI in a breast lesion favored malignancy. While as homogenus internal enhancement was mostly a feature of benign breast masses. We also found that MRI demonstrated a high sensitivity (100%) for picking up nodal involvement, however, it had a lower specificity (75%). So MRI can emerge as a vital tool in ruling out local node involvement with a high negative predictive value of 100%. CONCLUSION: MRI can be a useful tool for detecting multifocal breast diseases with their type and extent of involvement. It also facilitates disease staging and hence assists in changing the treatment plans and assessing the prognosis of disease in the patients

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