Role of Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS) in Differentiating Post Therapeutic Changes from Recurrent Malignant Breast Lesions

Abstract
Background: Patients follow-up subsequent to conservative breast therapy (BCT) is essential due to tumor recurrence with rates ranging between 1% and 2% annually. It occurs commonly during a period of 3-7 years after being subjected to BCT. Timely and early detection of breast cancer recurrence is believed to remarkably improve and assist long-term sur-vival.
Aim of Study: To assess new advances of Magnetic Res-onance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS) in diagnosis of recurrent breast cancer after conservative surgery, chemotherapy and radiotherapy and differentiate it from post therapeutic changes.
Patients and Methods: The current study was conducted on 20 patients proved to be breast carcinoma by histopatho-logical grading. Six patients were presented with breast lump, three patients were presented by nipple discharge, four patients were presented by diffuse breast enlargement and seven patients were presented for post-operative follow-up at El-Demerdash Hospital during the period from October 2018 to April 2019.
Results: A strong positive correlation is detected between choline peak findings and the level of Ki67, the higher the choline the higher the Ki67 the more aggressiveness is the tumor.
Conclusion: Both dynamic contrast enhanced MRI and MRS are valuable tools in the evaluation of post-operative breast having high sensitivity and specificity to differentiate between benign post-operative changes and recurrent malignant tumor. On the other hand, MRI on the breast can assist to avoid unnecessary interventions and optimizes diagnosis of recurrence in its early stages.