Magnetic resonance imaging in the preoperative evaluation of invasive lobular carcinoma; a useful investigation?

Aim: Quantify the added benefit of preoperative magnetic resonance imaging (MRI) staging of invasive lobular carcinoma of the breast (ILC) in addition to conventional imaging with ultrasound and mammography (US/MMG). Methods: Retrospective study ILC patients at our center to investigate effect of MRI in detecting additional disease, as well as effects on subsequent surgical management, reoperation rates and disease recurrence. Results: Preoperative MRI detected additional disease in 30.4% and altered surgical management in 39.1%. MRI better predicted histopathological lesion size but did not significantly alter reoperation or recurrence rates. Conclusion: MRI is superior in ILC detection and upstages a significant proportion of patients when used in preoperative staging. The impact on surgical outcomes warrants further investigation in larger prospective studies.