MRI-based quantification of residual fibroglandular tissue of the breast after conservative mastectomies

Ramona Woitek; Georg Pfeiler; Alex Farr; Panagiotis Kapetas; Julia Furtner; Maria Bernathova; Veronika Schöpf; Paola Clauser; Maria A Marino; Katja Pinker; Pascal A Baltzer; Thomas H Helbich

doi:10.1016/j.ejrad.2018.04.028

MRI-based quantification of residual fibroglandular tissue of the breast after conservative mastectomies

Eur J Radiol. 2018 Jul:104:1-7. doi: 10.1016/j.ejrad.2018.04.028. Epub 2018 Apr 26.

Authors

Affiliations

¹ Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria.
² Department of Obstetrics and Gynecology, Medical University of Vienna, Austria.
³ Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria.
⁴ Institute of Psychology, University of Graz, Austria.
⁵ Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G. Martino, University of Messina, Messina, Italy.
⁶ Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, USA.
⁷ Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria. Electronic address: thomas.helbich@meduniwien.ac.at.

Abstract

Purpose: Skin-sparing and nipple-sparing mastectomies (SSM; NSM) remove the breast's fibroglandular tissue (FGT), thereby reducing breast cancer risk. The postoperative presence of residual FGT (RFGT) is associated with remaining cancer risk. This study evaluated the role of MRI in the quantitative assessment of RFGT and its impact on the estimation of the remaining breast cancer risk.

Methods: The postoperative MRI scans (following EUSOMA recommendations) of 58 patients who had undergone SSM or NSM between 2003 and 2013, as well as preoperative MRI scans that were available in 25 of these patients, were retrospectively evaluated for the presence and location of RFGT by three radiologists. Two different observers quantitatively assessed the volume and percentage of retromamillary and other RFGT (RFGT_rm and RFGT_other) were assessed. The Fisher's exact test, the Student's t-test, and intraclass coherence were used to compare patient groups and to assess reproducibility.

Results: RFGT was found in 20% of all breasts and significantly more frequently after NSM than SSM (50% vs. 13%, p = .003). RFGT_rm and RFGT_other were more prevalent after NSM (p < 0.001; p = .127). RFGT ranged from 0.5 to 26% of the preoperative FGT, with higher percentages after NSM than SSM (p = .181).

Conclusions: The prevalence and percentage of RFGT found on MRI indicate a considerable remaining postoperative breast cancer risk in some women.

Keywords: Breast cancer; Imaging; Magnetic resonance imaging; Mammary glands; Mastectomy.

MeSH terms

Adult
Breast Neoplasms / pathology
Breast Neoplasms / prevention & control*
Breast Neoplasms / surgery
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Neoplasm Recurrence, Local / prevention & control*
Nipples* / diagnostic imaging
Nipples* / pathology
Organ Sparing Treatments*
Patient Satisfaction
Postoperative Period
Prophylactic Mastectomy* / methods
Reproducibility of Results
Retrospective Studies
Risk Assessment

Grants and funding

P30 CA008748/CA/NCI NIH HHS/United States