Abstract
Background
Assessment of pectoralis muscle invasion is important for treatment planning for breast cancer. We evaluated the usefulness of breast magnetic resonance (MR) imaging for the detection of tumor invasion of the pectoralis muscle in breast cancer patients. Materials and Method: A total of 306 breast MR examinations were performed preoperatively. Three-dimensional gradient echo sequences, at a section thickness of 1.5 or 2 mm were obtained with administration of gadolinium-DTPA. All patients underwent surgery.
Results
In 33 breasts, disruption of the fat plane between tumor and muscle was noted. Seven of 33 cases showed muscle enhancement contiguous to enhanced tumors. Pathology reports indicated that 5 of 7 of the tumors involved muscle invasion. Of the 2 false positive cases, one showed muscle enhancement because of a previous biopsy, and the other was incorrectly interpreted as showing muscle enhancement. Of the 26 breasts which did not demonstrate muscle enhancement, none were found at surgery to have tumor involvement.
Conclusion
Enhancement of the pectoralis muscle correlates well with muscle invasion, but there are a few potential pitfalls. Disruption of the fat plane between tumor and muscle, without muscle enhancement, might not indicate tumor involvement of the pectoralis muscle.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- MR:
-
Magnetic resonance
References
DiBiase SJ, Komarnicky, Schwartz GF, Xie Y, Mansfield CM: The number of positive margins influences the outcome of women treated with breast preservation for early stage breast carcinoma.Cancer 82:2212- 2220,1998.
Park CC, Mitsumori M, Nixon A,et al: Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence.J Clin Oncol 18:1668–1675, 2000.
Frykberg ER, Bland KI: Evolution of surgical principles for the management of breast cancer. In: Bland KI, Copeland EM eds, The breast: comprehensive management of benign and malignant diseases, W.B. Saunders, Philadelphia; pp539–569,1991.
Orel SG, Schnall MD, Powell CM,et al: Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy.Radiology 196:115–122,1995.
Hirose M, Suzuki H, Doi 0, Nakamura S, Saiki S, Yoshitome E: Utility of 3D MR mammography in determining the choice for conservation surgery of breast cancer (abstr).Radiology 197^(P):460,1995.
Morris EA, Schwarz LH, Drotman MB,et al: Evaluation of pectoralis major muscle in patients with posterior breast tumors on breast MR images: early experience.Radiology 214:67–72, 2000.
Fobben ES, Rubin CZ, Kalisher L, Dembner AG, Seltzer MH, Santoro EJ: Breast MR imaging with commercially available techniques: radiologic-pathologic correlation.Radiology 196:143–152,1995.
Kerslake RW, Carleton PJ, Fox JN,et al: Dynamic gradient-echo and fat-suppressed spin-echo contrast- enhanced MRI of the breast.Clin Radiol 50:440–454, 1995.
Orel SG, Schnall MD, Li Volsi VA, Troupin RH: Suspicious breast lesions: MR imaging with cardiologic- pathologic correlation.Radiology 190:485–493,1994.
Mueller RD, Barkhausen J, Sauerwein W, Langer R: Assessment of local recurrence after breast-conserving therapy with MRI.J Comput Assist Tomogr 22:408- 412,1998.
Heywang-Koebrunner SH, Schlegel A, Beck R,et al: Contrast-enhanced MRI of the breast after limited surgery and radiation therapy.J Comput Assist Tomogr 17:891–900,1993.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Kazama, T., Nakamura, S., Doi, O. et al. Prospective evaluation of pectoralis muscle invasion of breast cancer by MR imaging. Breast Cancer 12, 312–316 (2005). https://doi.org/10.2325/jbcs.12.312
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.2325/jbcs.12.312