Magnetic resonance in the diagnostics of invasive and in-situ breast carcinomas

Karcinom dojke čini najčešći karcinom u žena u Republici Hrvatskoj prema incidenciji i mortalitetu i kao takav predstavlja velik javnozdravstveni problem. U radiološkoj dijagnostici karcinoma dojke važno mjesto sve više zauzima magnetska rezonancija. MRI je slikovna dijagnostička tehnika koja omogućuje prikaz tkiva s velikom prostornom razlučivošću. Posljednjih godina, napretkom tehnologija na području MRI, njezina primjena u dijagnostici karcinoma dojke se uvelike proširila. Prema EUSOBI smjernicama MRI se koristi za pacijentice sa silikonskim implantatima; u probiru žena s visokim rizikom od karcinoma dojke; nejasnog nalaza pri konvencionalnom oslikavanju dojki; kod pacijentica sa metastazama, a nepoznatim primarnim tumorom; za određivanje proširenosti bolesti kod pacijentica s prethodno dijagnosticiranim tumorom; kod pacijentica s parcijalnom resekcijom dojke gdje je potrebno razlikovati ožiljak od lokalnog recidiva tumora; za procjenu terapijskog odgovora neoadjuvantno primijenjene kemoterapije te biopsija pod kontrolom MRI koja u Republici Hrvatskoj nije dostupna. Široj dijagnostičkoj primjeni doprinio je i BI-RADS klasifikacijski sustav koji donosi standardizaciju terminologije korištene u interpretaciji nalaza MRI. Unatoč visokoj osjetljivosti MRI u dijagnostici karcinoma dojke, ono što predstavlja određen nedostatak je relativno niska specifičnost. MRI predstavlja svakako važan dio dijagnostike invazivnih i in-situ karcinoma dojke, no njezina prava vrijednost i mogućnosti i dalje su tema brojnih istraživanja.Breast cancer is the most common cancer in women in the Republic of Croatia according to the incidence and mortality and as such represents a major public health problem. Magnetic resonance imaging is becoming more important in the radiologic imaging of the breast cancers. MRI is a diagnostic imaging technique that allows the display of tissue with high spatial resolution. Application of MRI in the diagnosis of breast cancer has greatly expanded in the recent years due to the advances in the field of MRI technology. According to the EUSOBI guidelines, MRI is used in patients with silicone implants; screening of patients with a high risk of breast cancer; inconclusive findings in conventional breast imaging; in patients with diagnosed metastases, but unknown primary tumor site; to determine the extent of disease in patients with previously diagnosed tumor; in patients with partial resection of the breast where it is necessary to distinguish between the scar tissue and the local recurrence of the tumor; for the assessment of the therapeutic response after neoadjuvant chemotherapy and for MRI-guided biopsy that is not available in the Republic of Croatia. BI-RADS classification system contributed to the wider application of the MRI by presenting the standardization of terminology used in the interpretation of MRI findings. Despite the high sensitivity of the MRI in the diagnosis of breast cancers, relatively low specificity is a certain drawback. MRI represents an important part of the diagnosis of invasive and in-situ carcinomas of the breast, but its true value and potential are still the subjects of numerous studies