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Magnetic Resonance Imaging-Guided Breast Intervention and Surgery

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Intraoperative Imaging and Image-Guided Therapy

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Abstract

The use of contrast-enhanced breast magnetic resonance imaging (MRI) as an important adjunctive modality for screening and diagnosis of breast cancer is rapidly increasing. Breast MRI is highly sensitive for detection of malignancy and may reveal suspicious breast lesions that are occult to physical examination and by conventional imaging modalities (mammography and ultrasound). In these cases MR-guided breast interventions are essential for tissue sampling to determine the histology of abnormalities detected by only MRI.

Presently there is no satisfactory method of margin evaluation during surgery. The use of MRI guidance and evaluation of the margins intraoperatively is expected to reduce the need for re-excision (current rates of 2nd operations to obtain clear margins are approximately 40 %). This chapter will describe appropriate peer-reviewed data of established methods for MR-guided tissue sampling and currently accepted MR-guided therapeutic methods for benign and malignant breast diseases, including intraoperative imaging. Emerging techniques for margin assessment, including non-MR-based methods, are also surveyed.

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Authors and Affiliations

  1. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Eva C. Gombos MD

  2. National Center for Image Guided Therapy, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Daniel F. Kacher MS & Jagadeesan Jayender PhD

  3. Department of Surgery, Hallmark Health System Comprehensive Breast Center, Stoneham, MA, USA

    Diana L. Caragacianu MD

  4. Breast Surgical Services, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston, MA, USA

    Mehra Golshan MD, FACS

  5. Department of Surgery, Harvard Medical School, Boston, MA, USA

    Mehra Golshan MD, FACS

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  1. Eva C. Gombos MD
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  5. Mehra Golshan MD, FACS
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Correspondence to Eva C. Gombos MD .

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  1. National Center for Image Guided Therapy, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

    Ferenc A. Jolesz

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Gombos, E.C., Kacher, D.F., Caragacianu, D.L., Jayender, J., Golshan, M. (2014). Magnetic Resonance Imaging-Guided Breast Intervention and Surgery. In: Jolesz, F. (eds) Intraoperative Imaging and Image-Guided Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7657-3_62

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