Magnetska rezonancija u preoperativnoj dijagnostici karcinoma dojke

master's thesis

• Title (english): Magnetic resonance imaging in preoperative assessment of breast cancer
• Author: Sara Tomašinec
• Mentor: Maja Prutki (mentor)
• Committee member: Gordana Ivanac (predsjednik povjerenstva)
• Committee member: Milan Radoš (član povjerenstva)
• Committee member: Maja Prutki (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Cilj. Svrha istraživanja je retrospektivno analizirati točnost preoperativnog MR pregleda u procjeni postojanja dodatnih tvorbi u dojkama kod bolesnica s dijagnosticiranim karcinomom dojke i analizirati kako nalaz MR-a utječe na terapijski postupak kod bolesnica. ----- Materijali i metode. U retrospektivno istraživanje uključeno je 20 bolesnica kod kojih je biopsijom širokom iglom potvrđen karcinom dojke. Kod svih bolesnica učinjen je preoperativni MR pregled dojki. Ukoliko je nalaz MR-a ukazao na postojanje suspektnih tvorbi, kod bolesnica je učinjena biopsija dojke širokom iglom ili je učinjena kirurška biopsija. Uspoređene su odluke o vrsti operacijskog zahvata donesene temeljem nalaza MR pregleda dojki. ----- Rezultati. MR pregledom je otkriveno ukupno 13 novih lezija. Biopsijom je utvrđeno da je 6 tvorbi (46,2%) je bilo maligno, a 7 (53,9%) benigno. U ipsilateralnoj dojci je MR-om pronađeno osam novih tvorbi, četiri su bile maligne i četiri tvorbe su bile benigne. U kontralateralnoj dojci je otkriveno pet lezija, od toga dvije maligne i tri benigne tvorbe. Kod 12 bolesnica (60,0%) nalaz MR-a nije imao učinka na odluku o terapijskom postupku. Kod dvije (10,0%) bolesnice temeljem nalaza MR-a učinjena je mastektomija, a lokalna ekscizija tumora proširena je kod tri (15,0%) pacijentice. U dvije (10,0%) bolesnice je učinjena biopsija lezija otkrivenih na MR-u te je napravljena dodatna markacija tvorbi žicom prije operacijskog zahvata. Jedna pacijentica je upućena na neoadjuvantnu kemoterapiju prije operativnog zahvata. ----- Zaključak. MR vrlo vrijedna i pouzdana metoda u otkrivanju dodatnih žarišta malignih procesa koji su ostali skriveni konvencionalnim metodama oslikavanja dojke, kako u ipsilateralnoj, tako i u kontralateralnoj dojci. Utvrđeno je da nalaz MR-a ima značajan utjecaj na terapijski pristup karcinomu dojke. Kod 40,0 % bolesnica, temeljem nalaza MR-a došlo je do promijene terapijskog plana u liječenju karcinoma dojke.

Abstract (english)

Aim. The purpose of this study is to retrospectively evaluate the accuracy of preoperative breast MRI in detection of additional breast tumours and to analyze the impact of preoperative MRI on the treatment among women with newly diagnosed breast cancer. ----- Materials and methods. The retrospective study included 20 women with core needle biopsy proven malignant breast tumour. All of the patients underwent preoperative bilateral breast MRI. A core needle biopsy or a surgical biopsy was done if there were any suspected lesions detected by MRI. A comparison between surgical plans prior and post MRI was made. ----- Results. Bilateral breast MRI detected 13 additional previously unsuspected lesions. Biopsy identified 6 lesions (46,2%) as malignant and 7 (53,9%) lesions as benign. MRI detected eight new lesions in the ipsilateral breast, four of them were malignant and four were benign. Five new lesions were detected in the contralateral breast, two were malignant and three were benign. MRI results did not have any impact on the therapy procedure in 12 patients (60,0 %). A mastectomy was done in two (10,0%) patients based on the MRI results, and a wider local excision was done in three (15,0 %) patients. Two patients (10,0 %) underwent an additional wire localization procedure before the operation. One patient underwent neoadjuvant chemotherapy before the operation. ----- Conclusion. MRI is a valuable and reliable method in detecting additional malignant tumours that remained hidden from the reach of conventional breast imaging methods, both in the ipsilateral and contralateral breasts. The study has shown that preoperative MRI has a big effect on the therapy approach to breast cancer. In 40,0 % of patients preoperative MRI caused alteration of breast cancer treatment plans.

• Keywords: karcinom dojke; predoperativni MR dojke; kirurgija karcinoma dojke
• Keywords (english): breast cancer; preoperative breast MRI; breast cancer surgery
• Language: croatian
• URN:NBN: urn:nbn:hr:105:337127
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-04-04 07:16:34