Formulation of a System for MRI Diagnosis of Breast Cancer Based on Community Medicine Cooperation

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  • 地域医療連携を通じた乳腺MRI診断プロセスの構築

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When breast cancer is suspected on the basis of mammography (MMG) or ultrasonography (US), MRI may be requested at neighboring facilities if diagnosis is difficult. However, no standard protocol has yet been established. We therefore conducted a trial to establish an appropriate diagnostic protocol by defining the object standard and examination method for such cases. When it is difficult to perform core needle biopsy (CNB) using US, even though breast cancer is suspected on the basis of MMG or US examination, we apply MRI. We created a MRI protocol (the “Sora-cli protocol”) employing mainly high-resolution scan in the early enhanced phase for the site of breast disease. The breast surgeon and radiologic technologist at our clinic referred to BI-RADS-MRI, evaluated the MRI image together, and determined the subsequent medical strategy. This made it possible to unify the procedure at MRI facilities with the intention of request side. The MRI images suggestive of malignancy in 11 out of 19 cases made into the object appeared. Furthermore, additional study detected 8 cases of breast cancer. Detailed pathological changes can be detected by conducting additional studies when there are signs suggestive of malignancy on MRI, and if no abnormality is evident, subsequent unnecessary additional examinations can be avoided. In addition, it seems that high-resolution scans in the early enhanced phase are excellent for assessment of early breast cancers that have not yet formed tumors. Although variations in medical standards are problematic, it is considered necessary to establish a proper standard and medical organization in order to offer good medical treatment, irrespective of area or environment. Therefore this trial was considered useful.

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