Sona Ajit Chikarmane BS, Presenter: Nothing to Disclose

Eva Csilla Gombos MD, Abstract Co-Author: Nothing to Disclose

Lukman Ahmed BA, Abstract Co-Author: Nothing to Disclose

Sughra Raza MD, Abstract Co-Author: Nothing to Disclose

Gabriel Griffin BA, Abstract Co-Author: Nothing to Disclose

Robyn Leah Birdwell MD, Abstract Co-Author: Nothing to Disclose

Breast magnetic resonance (MR) has been suggested as an adjunct imaging tool to detect recurrence at the lumpectomy site in patients treated with breast conservation therapy (BCT). However, limited data exists as to the outcome of MR enhancement patterns of the site. Our goal was to study the follow-up and outcome of enhancement patterns at lumpectomy sites assessed as probably benign (BI-RADS 3).

Retrospective, IRB-approved review of our database between August 1, 2005-July 31, 2007 revealed 483 women who underwent breast MR following BCT with lumpectomy and external beam radiation therapy. These consecutive cases were reviewed for indications, lesion and enhancement characteristics as reported, follow-up imaging, and intervening histology.

Of the 483 women treated with BCT who underwent MR during the study period, 208/483 (43%) were found to have variable degrees of enhancement at the lumpectomy site. Average time interval between therapy and MR ranged from 2 months to 15 years. Assessment of the treated breast was probably benign in 43/483 (9%) post-lumpectomy patients with 47 findings reviewed, or 43/210 (20%) of women with variable enhancement at their lumpectomy site. Two patients with 2 findings were lost to follow-up, leaving 41 women with 45 findings. Enhancement patterns (n=45) included: non-specific enhancement of the lumpectomy site (n=16), nonmass-like enhancement (n=11), rim-enhancing seroma (n=5), solitary focus (n=6), mass (n=5), and multiple foci (n=2). Of the 45 findings, 7 (16%) underwent biopsy, with 0/45 (0%) malignancies. The remaining 38 (84%) were followed up with imaging for: 16 (42%) ≥ 2 yrs, 15 (40%) ≥ 12 mo, or 7 (18%) with at least a single 6-mo MR.

BI-RADS 3 assessment was given to 9% of all women treated with BCT or 21% of women who had variable enhancement at their lumpectomy site. No cases of malignancy were found in the study population. The most common enhancement pattern was non-specific enhancement of the lumpectomy site, which suggests that short-interval follow-up may not be necessary in these particular cases.

Probably benign assessment of enhancement at the lumpectomy site in women treated with BCT has a low risk of malignancy and, therefore, enhancement with non-specific findings may be considered benign.

Chikarmane, S, Gombos, E, Ahmed, L, Raza, S, Griffin, G, Birdwell, R, Outcome of the Probably Benign (BI-RADS 3) Magnetic Resonance Imaging Assessment in the Treated Breast in Women after Lumpectomy and Radiation Therapy.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017763.html