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Centre for Evidence-
Based Medicine

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