Abstract

Dr. Sabeeha Gul*, Dr. Mir Saiqa Shafi, Dr. Rehana Afshan, Dr. Prof. Tariq Gojwari

ABSTRACT

Background: Our study included all of the female patients presenting to the OPD of the departments of General Surgery and Radiation Oncolgy with breast masses, that were palpable or either ultrasound or mammography documented. All the patients were worked up as per the set proforma before a contrast MRI of breasts was done on them to see for detection and characterization of breast disease along with assessment of local extent of the disease and guidance for biopsy with further correlation on HPE. Aim: To study the morphological characteristics of benign and malignant breast masses using various MR sequences as its safer and has better correlationship with HPE. Methods: In our study we performed a prospective study for a total period of two years which included total of 60 patients from varied age groups, ranging from adolescents to elderly. Female patients with breast masses, where worked up as per the set proforma before the contrast MRI of breasts was done. 1.5-Tesla MRI system with a dedicated four-channel dual breast coil was used. Chest survey was done with STIR and T1W sequences acquired in an axial plane. Precontrast fat-suppressed T1W gradient-echo images were first obtained and this was followed by intravenous contrast injection. Gadodiamide (GdDTPA-BMA), 0.1 mmol/kg body weight bolus, using a pressure injector with a flow rate of 2.0 ml/s, followed by a flush of 20 ml of saline was used and dynamic scans were then obtained. All observations where made note of to see for type, extend and staging of breast diseases in these patients and samples sent for histopathological examination (HPE) for correlation. Results: We inferred that MRI Showing masses with lobulated or irregular shape and spiculations had more chances of being malignant and on the contrary, masses with round or oval shape with smooth margins were more likely to be benign as reiterated by final biopsy and HPE. Also lesions with heterogenous, rim and central enhancement pattern on MRI in a breast lesion favoured malignancy. While as homogenus internal enhancements were mostly a feature of benign breast masses further reinforced by HPE. Conclusion: MRI and subsequent HPE can be a useful tool for detecting type, extend and staging in multifocal breast.