MRI plays an important role in pregnancy-associated breast cancers

A recent study published in the American Journal of Roentgenology states that breast MRI may play an important role in the management of pregnancy-associated breast cancers (PABC).

PABC is defined as breast cancer occurring during pregnancy or within one year of delivery. It occurs in 1 in 3,000 to 10,000 pregnancies, making it relativley rare. But when it does occur, it can lead to recurrence and death.

The purpose of the study, led by Kelly S. Myers of Johns Hopkins Hospital and others, was to describe the appearance of PABC on MRI and to consider the impact of preoperative MRI on patient management.

The study reviewed 53 patients who had available MR images for review. Nine of the patients presented cancer during pregnancy and 44 presented cancer with in the first year postpartum.

• The sensitivity rate of the MRI was 52 of 53 patients (98 percent).
• Breast MRI changed surgical management for 15 patients (28 percent).
• The MRI also changed surgical management for 28 percent of those patients.
• 29 patients (55 percent) of patients’ MRI included a solitary mass.
• 12 patients (23 percent) of patients had a non-mass enhancement.
• 8 patients (15 percent) of patients had multiple masses.
• 12 patients (23 percent) of patients showed a pathologically proven larger tumor size or greater extent of disease than did mammography or ultrasound.
• 8 patients (15 percent) of patients have findings suspicious for greater extent of disease but have unavailable pathologic data.

"Preoperative planning is especially important for patients with pregnancy-associated breast cancer because of the often aggressive nature of these cancers," Myers  et al. wrote. "In contrast to the previous assumption that breast MRI would be of limited utility in this population, we found that it showed a pathologically proven larger tumor size or greater extent of disease in 23 percent of patients."

The study adds to the current literature regarding breast MRI for patients with PABC—but more research is still needed.

“To our knowledge, only one small study to date has reported the appearance of PABC on MRI, and that study reported findings for only five patients,” the authors wrote. “The present study of 53 patents with pregnancy-associated breast cancer who underwent breast MRI therefore is, to our knowledge, the largest such study to date.”