Sylvia Helen Heywang-Koebrunner MD, Presenter: Nothing to Disclose

Anke Heinig MD, Abstract Co-Author: Nothing to Disclose

M. Omenzetter, Abstract Co-Author: Nothing to Disclose

Contrast-enhanced (CE)-MRI is a very sensitive method for the detection of malignancy. However, nonspecific contrast enhancement of benign tissue can impair assessment by obscuring or mimicking malignancy. Short-term anti-estrogen treatment reduces nonspecific contrast enhancement of benignl breast tissues; however, for diagnostic applications in breast cancer patients, it must be determined to what extent this treatment also suppresses contrast enhancement of the malignancy itself. This study was designed to investigate the effects of short-term treatment with exemestane, a steroidal aromatase inactivator, on CE-MRI of benign and malignant breast tissues.

Patients with breast cancer underwent CE-MRI on study day 0 and were treated with exemestane 25 mg po qd until surgery. During this time, they underwent weekly CE-MRI until the day of definitive surgery. Enhancement was evaluated visually and quantitatively by independent review of 2 experienced readers.

A total of 22 patients were examined. There were 2 withdrawals due to early excision. One tumor appeared slightly smaller during treatment with exemestane. In 7 patients, the enhancement curve flattened slightly during exemestane treatment. However, all malignant tumors remained clearly visible. Reduced enhancement was seen in the following benign changes: 2/5 changes with focal and 5/8 changes with diffuse enhancement. 2 fibroadenomas and 1 inflammatory change continued to enhance.

Short-term treatment before MRI with exemestane does not markedly influence CE-MRI enhancement of breast tumors, while nonspecific enhancement of normal tissue is reduced. Neoadjuvant use of exemestane may thus improve the diagnostic accuracy of CE-MRI in breast cancer patients.

S.H.H.,A.H.,M.O.: The study was supported by Pharmacia , which paid to the hospital for MRI studies and supplied the medication of the investigator initiated study.

Heywang-Koebrunner, S, Heinig, A, Omenzetter, M, Short-term Use of Neoadjuvant Exemestane Improves the Diagnostic Accuracy of Contrast-enhanced MRI in Breast Cancer Patients.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4416152.html