Taehee Kim MD, PhD, Presenter: Nothing to Disclose

Seon Young Park MD, Abstract Co-Author: Nothing to Disclose

Young Keun Sur MD, Abstract Co-Author: Nothing to Disclose

Doo Kyoung Kang MD, Abstract Co-Author: Nothing to Disclose

We want to evaluate whether the background parenchymal enhancement (BPE) would decrease after preoperative tamoxifen treatment in breast cancer patients with moderate or marked BPE. Also, we want to evaluate if it could reduce false positive rate and improve the specificity of MRI.

From October 2013 to March 2014, twenty-five premenopausal patients with moderate or marked BPE on preoperative MRI were included in the image analysis. These patients underwent preoperative MRI twice, before and after tamoxifen intake. Mean treatment period with tamoxifen was 9 days (range, 5-33days). The signal intensity of the parenchyma was measured using four ROIs around the index cancer, and at the middle of the parenchyma of contralateral breast. Suspicious enhancing lesions besides index cancer were evaluated, around the index cancer, in other quadrant of ipsilateral breast, and in contralateral breast.

Among twenty-five patients, eight patients showed marked BPE and seventeen patients showed moderate BPE. On qualitative analysis, all 8 patients with marked BPE and 7 of 17 patients with moderate BPE showed BPE decrement after tamoxifen treatment. On quantitative analysis, the mean degree of parenchymal enhancement decreased from 93.5% to 73.4% after tamoxifen treatment. Tumor margins were non-visualized in 6 patients initially, which became distinct after tamoxifen treatment. Suspicious enhancing lesions besides index cancer were located around the index cancer in 12 patients, in other quadrant of ipsilateral breast in 3 patients, and in contralateral breast in 8 patients. These enhancements showed disappearance after tamoxifen treatment, resulting as a normal looking parenchyma.  

Preoperative tamoxifen treatment in breast cancer patients with moderate or marked BPE could reduce false positive diagnostic rate and help to evaluate the accurate cancer margin and extent.

Preoperative tamoxifen treatment can decrease background parenchymal enhancement (BPE), and is recommended in breast cancer patients with moderate or marked BPE for reduction of false positive diagnostic rate and accurate evaluation of cancer margin and extent.

Kim, T, Park, S, Sur, Y, Kang, D, Preoperative Tamoxifen Treatment in Breast Cancer Patients with Moderate or Marked Parenchymal Enhancement: Could It Decrease Background Parenchymal Enhancement and Improve the Accuracy of Cancer Extent Evaluation?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010466.html