RESUMEN
Breast magnetic resonance imaging (MRI) has been repeatedly shown to have a high false-positive rate for additional findings in the breast resulting in additional breast imaging and biopsies. We hypothesize that breast MRI is also associated with a high rate of false-positive findings outside of the breast requiring additional evaluation, interventions, and delays in treatment. We performed a retrospective review of all breast MRIs performed on breast cancer patients in 2010 at a single institution. MRI reports were analyzed for extra-mammary findings. The timing and yield of the additional procedures was also analyzed. Three hundred and twenty-seven breast cancer patients (average age = 53.53 ± 11.08 years) had a breast MRI. Incidental, extra-mammary findings were reported in 35/327 patients (10.7%) with a total of 38 incidental findings. The extra-mammary findings were located in the liver (n = 21, 60.0%), thoracic cavity (n = 12, 34.3%), kidneys (n = 1, 2.9%), musculoskeletal system (n = 3, 8.6%), and neck (n = 1, 2.9%). Eighteen of the 35 patients (51.4%) received additional radiographic imaging, 3 (8.6%) received additional laboratory testing, 2 (5.7%) received additional physician referrals and 2 (5.7%) received a biopsy of the finding. The average time to additional procedures in these patients was 14.5 days. None of the incidental, extra-mammary findings were associated with breast cancer or other malignancy. Breast MRI was associated with a high rate (10.7%) of extra-mammary findings, which led to costly additional imaging studies, referrals, and tests. These findings were not associated with breast cancer or other malignancies. Extra-mammary findings highlight an unrecognized adverse consequence of breast MRI.
Asunto(s)
Neoplasias de la Mama/patología , Hallazgos Incidentales , Imagen por Resonancia Magnética/métodos , Adulto , Reacciones Falso Positivas , Femenino , Humanos , Riñón/diagnóstico por imagen , Riñón/patología , Hígado/diagnóstico por imagen , Hígado/patología , Medicare , Persona de Mediana Edad , Cuello/diagnóstico por imagen , Cuello/patología , Radiografía/economía , Estudios Retrospectivos , Estados UnidosRESUMEN
Hereditary syndromes that increase the risk of breast cancer are not common, but it is critical to recognize and manage them appropriately. This paper reviews the management of patients with the most common hereditary breast cancer syndromes, ie, hereditary breast and ovarian cancer syndrome, hereditary diffuse gastric cancer, Cowden syndrome (PTEN hamartoma tumor syndrome), Peutz-Jeghers syndrome, and Li-Fraumeni syndrome.