ABSTRACT
Preoperative assessment: How far to go in Imaging
DALILA AHNOU Radiology Breast Unit, University Hospital Beni Messous, Alger, Algeria
The key parameters in the evaluation of the extension of a breast cancer are the tumor size, the existence of a multifocality or a multicentricity, the lymph node extension and the distant metastases. In the evaluation of the tumor size, the reliability of MRI is superior to the couple (ultrasound, mammography) especially in dense breasts. Tomosynthesis is more effective than mammography in measuring tumor size because it is better at visualizing the lesion contours.
Evaluation of the size of a focus of micro-calcifications is done on enlarged mammographic images of the face and profile. 15-20% of additional cancers are detected on MRI in patients with associated risk factors. The performance of angiography is equivalent to MRI and can be an alternative when there is a contraindication, notably claustrophobia.
Ultrasound is the method of choice for exploration of the axillary cavity in search of a suspicious node. Thoracic-abdominal-pelvic CT and 18FDG PET scan are to be preferred in the assessment of metastatic extension.
Key words: MRI, Extensional assessment, Tumor size, Additional lesions
