Evidence map›Paper›PMID 30229271›Full record

ArticleEuropean radiology2019

Background parenchymal enhancement in pregnancy-associated breast cancer: a hindrance to diagnosis?

Jana Taron, Sabrina Fleischer, Heike Preibsch, Konstantin Nikolaou, Ines Gruber, Sonja Bahrs

Abstract read
PubMed Publisher
In one paragraph

Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Breast Imaging and Intervention during Pregnancy and Lactation.Radiographics : a review publication of the Radiological Society of North America, Inc · 2023
    Article
  5. Cancer in pregnancy: breast cancer.Abdominal radiology (New York) · 2023
    Review
  6. Review
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jana TaronDepartment of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany. jana.taron@med.uni-tuebingen.de.
Sabrina FleischerDepartment of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
Heike PreibschDepartment of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
Konstantin NikolaouDepartment of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
Ines GruberGynecology and Obstetrics, University Hospital Tuebingen, Tuebingen, Germany.
Sonja BahrsDepartment of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
University of Tübingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study is to investigate the detectability of pregnancy-associated breast cancer (PABC) in lactating glandular tissue on magnetic resonance imaging (MRI) by using pre- and post-contrast acquisitions and their derived postprocessed images and compare these results to ultrasound (US) and mammography (MG). MATERIALS AND

methodsWe reviewed the electronic database for women with PABC and existing breast MRI. MR images (T2-weighted short inversion-recovery sequence [STIR], dynamic contrast-enhanced T1-weighted gradient echo sequence and postprocessed subtraction images [early post-contrast minus pre-contrast]) were retrospectively evaluated (image quality, parenchymal/tumour enhancement kintetics, tumour size and additional lesions). Supplemental subtraction images (latest post-contrast minus early post-contrast) to reduce plateau enhancement were additionally calculated and tumour conspicuity and size were measured. Findings were compared to US and MG reports.

resultsNineteen patients (range 27-42 years) were included. Background parenchymal enhancement (BPE) was minimal (n=1), mild (n=3), moderate (n=7) and marked (n=8) with kinetics measured plateau (n=8), continuous (n=10) and not quantifiable (n=1). Tumour kinetics presented wash-out (n=17) and plateau (n=2). Eighteen of nineteen tumours were identified on the supplemental subtraction images. All tumours were visible on US; 12/19 were visible on MG (63.2%). MRI detected additional malignant lesions in two patients.

conclusionDespite high BPE of the lactating breast, MRI securely detects carcinomas and identifies satellite lesions. By using supplemental subtraction images, background enhancement can be eliminated to facilitate diagnosis. US remains a reliable diagnostic tool, but additional MRI is recommended to rule out satellite/contralateral lesions. MG interpretations can be difficult due to high parenchymal density. KEY POINTS: • Despite high background enhancement, MRI of the breast confidently detects carcinomas and identifies further lesions in the lactating breast. • By using supplemental subtraction images, background enhancement in the lactating breast can be eliminated to facilitate diagnosis. • US remains a reliable diagnostic tool. Mammography can be limited due to extremely dense breast tissue related to lactation.

Indexed as

LactationAdultBreastBreast NeoplasmsFemaleHumansImage EnhancementMagnetic Resonance ImagingMammographyMiddle AgedPregnancyRetrospective StudiesBreast cancerMagnetic resonance imagingPregnancy

Identifiers

PMID30229271
OpenAlexW2889957610

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.