유방보존술을 시행받는 유방암환자에서 재절제 예측의자기공명영상소견유방보존술을 시행받는 유방암환자에서 재절제 예측의자기공명영상소견유방보존술을 시행받는 유방암환자에서 재절제 예측의자기공명영상소견

Abstract

Purpose : The aim of this study was to determine the magnetic resonance imaging (MRI) features associated with re-excisiondue to the presence of a positive margin after breast conserving therapy (BCT) in breast cancer patients. Materials and Methods: We reviewed the records of 286 consecutive breast cancer patients who received BCT betweenJanuary 2006 and December 2007. Among 246 patients who had undergone BCT, 38 (15.4%) underwent immediatefurther surgery due to positive margin status. We analyzed the MRI findings using χ2 test, Fisher’s exact test and t tests. Multivariate logistic regression was conducted for prediction of re-excision. Results: Tumor size (p < 0.001), lesion multiplicity (p = 0.003), and non-mass-like enhancement (NMLE) type on MRI (p <0.001) were associated with margin involvement in BCT. On preoperative MRI, larger size (≥ 5 cm) (odds ratio = 2.96),NMLE (odds ratio = 3.81), and multifocal lesions (odds ratio = 2.54) were positively associated with re-excision. In casesinvolving NMLE, segmental distribution was associated with a greater likelihood of immediate re-excision. Conclusion: Larger size, multiplicity, and NMLE on MRI are significantly associated with re-excision after BCT in breastcancer patients. For NMLE lesions, the segmental distribution pattern was predictive of re-excision.