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Congress: ECR25
Poster Number: C-15016
Type: Poster: EPOS Radiologist (scientific)
Authorblock: S. Broitman, O. Golan, T. Menes, R. Kessner, R. Neeman, D. Stav, S. Lazar, Y. Nechyporenko, Y. Amitai; Tel Aviv/IL
Disclosures:
Shani Broitman: Nothing to disclose
Orit Golan: Nothing to disclose
Tehillah Menes: Nothing to disclose
Rivka Kessner: Nothing to disclose
Rina Neeman: Nothing to disclose
Dana Stav: Nothing to disclose
Sapir Lazar: Nothing to disclose
Yuliya Nechyporenko: Nothing to disclose
Yoav Amitai: Nothing to disclose
Keywords: Breast, Interventional non-vascular, MR, Biopsy, Localisation, Cancer
Results

Fifty-seven women who met the inclusion criteria were enrolled in the study.

The mean age of the participants was 55 years (range 35-79). Twenty-six percent of the women had a family history of breast cancer, and 17% had a personal history of the disease. Eighteen percent of women had involved lymph nodes. The most frequent pathological diagnosis was a combination of infiltrative ductal carcinoma (IDC) and DCIS (24/57, 42%), followed by isolated DCIS (26%) and isolated infiltrative lobular carcinoma ILC) or IDC (16% each). 

The predominant disease pattern observed was unifocal continuous (67%), followed by multifocal (32%), with only one case of multicentric disease.

MRI bracketing was performed using clip insertion in 49 out of 57 cases (84%), while MRI-compatible wires were used in the remaining 8 cases. Most commonly, two clips or wires were used for bracketing (20/57, 35%), although the number ranged from 1 to 4.

Positive margins were identified in 10 out of 57 cases (18%) on final surgical pathology. 

Younger age (Mean 56 vs 49) and the presence of DCIS or ILC component (100% vs 82%) were most closely associated with positive margins. Nonetheless, these association did not reach statistical significance (P=0.11 and P=0.149, respectively).

The precise status of the bracketed lesions could not be confidently determined from the available pathology reports in 8 patients. Among the remaining 49 patients, 13 (27%) had their bracketed regions classified as benign. Univariate analysis identified several factors associated with imaging overestimation, including smaller tumor size, bracketed enhancing foci, non-continuous disease (multifocal/multicentric) and isolated IDC. However, on multivariate analysis, only isolated IDC remained statistically significant predictor of imaging over estimation (38% vs 3%, P-0.008). Bracketing of enhancing foci showed borderline significance (54% vs 22%, P=0.084).

The median follow-up duration was 30 months (range: 0–96 months).Overall, 5 women (9%) were diagnosed with tumor recurrence during follow-up. Among the 5 recurrences, 2 were local (both DCIS) and 3 were distant (involving the liver in 2 cases and bone metastases in 1 case). One patient with local recurrence underwent a mastectomy.