高橋 徹 東北大学, 加齢医学研究所, 教授 (10004590)
SATOMI Susumu Tohoku Univ.Sch.Med.Professor., 医学部, 教授 (00154120)
ISHIBASHI Tadashi Tohoku Univ.Sch.Med.Associate Prof., 医学部, 講師 (40151401)
YAMADA Shogo Tohoku Univ.Sch.Med.Professor., 医学部, 教授 (60158194)
HARADA Yuko Tohoku Univ.Sch.Med.Reseach Associate, 医学部附属病院, 助手 (90292317)
|Budget Amount *help
¥2,100,000 (Direct Cost : ¥2,100,000)
Fiscal Year 1997 : ¥600,000 (Direct Cost : ¥600,000)
Fiscal Year 1996 : ¥1,500,000 (Direct Cost : ¥1,500,000)
Now, definition of carcinoma extension becomes more important, as breast conserving therapy is accepted as one of the treatment options. This study was initiated to clarify the ability of magnetic resonance imaging (MRI) in defining the extension of breast carcinoma, in comparison with the pathologic finding created by subserial sectioning of the specimens.
[Materials and Methods]
Prior to surgery the MRI was performed to 34 patients with breast cancer, then extension of tumors were 3 dimensionally assessed in maximum intensity projection (MIP). Each 3-D MIP was compared to the respective pathologic distribution of carcinoma obtained by subserial mapping.
[Results and Discussion]
Three imaging patterns were obtained, e.g., 1) localized (n=20), 2) segmental (n=11), and 3) random extensive (n=3) types. Among the specimens classified in localized type, 18 were defined in the TDLU,and intraductal spread of carcinoma to the nipple as long as 4 cm of extension, was observed in 2 specimens. In most of the specimens with segmental type carcinomas distributed along the duct-lobular system from the TDLU to the large duct. Clearly stained tumors in the MRI were histologically revealed to be DCIS which forms solid mass. Three were categorized as random extensive type with linear architecture, and were histologically defined to be carcinomas with diffuse stromal invasion as intraductal spread.
Conventional mammography and ultrasonography underestimated carcinoma extension in 6 of the 14 patients who were categorized as segmental, or random extensive type by the MRI,suggesting that the MRI is more appropriate to estimate carcinoma distribution prior to surgery. Ten percent (2/20) of patients with localized type, however, were not visualized in the MRI.Further investigation is required to develop the diagnostic technology in clinical utilization of MRI for breast conserving surgery.