Breast cancer recurrence: MRI may help in the diagnosis
Clinical Bottom Line
MRI may be helpful in the diagnosis of local recurrence of breast cancer.
Citation
Drew PJ, Kerin MJ, Turnbull LW, Imrie M, Carleton PJ, Fox JN & Monson JRT. Routine screening for local recurrence following breast-conserving therapy for cancer with dynamic contrast-enhanced magnetic resonance imaging of the breast. Ann Surg Oncol 1998;5:265-70
Clinical Question
In a patient with a history of breast cancer and breast conserving surgery, what is the best method for detecting local recurrence?
Search Terms
breast cancer and recurrence and screening in Medline
The Study
- The Study Patients: women with breast cancer undergoing breast conserving surgery
| Study Feature | Yes | No | Can't Tell |
|---|---|---|---|
| Independent? | x | ||
| Blind? | x | ||
| Standard applied regardless of test result? | x | ||
| Appropriate spectrum...? | x |
- Target disorder and Gold Standard: mammography and palpation
- Diagnostic test: MRI
The Evidence
| Disorder | |||||
|---|---|---|---|---|---|
| Present | Absent | ||||
| Test Result | Num. | Prop. | Num. | Prop. | LR |
| Positive | 9 | a | 6 | b | 16.00 |
| Negative | 0 | c | 90 | d | 0.00 |
- Sensitivity: 100%; CI: 100 to 100
- Specificity: 94%; CI: 89 to 98
- Prevalence: 9%; CI: 3 to 14
- Positive Predictive Value: 60%; CI: 51 to 69
- Negative Predictive Value: 100%; CI: 100 to 100
Comments
Small numbers
Particular to my patient:
Pre-test probability: 20%
Test Result Post-test probability
Positive 80%
Negative 0%
Expiry Date
Kill or Update by: 2001