9 The exception to this pattern is the basal-like and triple-negative breast cancers, which have a predilection for visceral and central nervous system metastases and infrequently involve bone. A recent study demonstrated the bone, lung, and liver to be the most common anatomical sites of distant metastases in patients with breast cancer, with 21.9% presenting with multisite involvement. 7,8 Therefore, all detected findings must be carefully considered. 7Įven with significant advances in breast cancer treatment, up to 70% of node-positive breast cancers will relapse and 20% to 30% of women with stage I and II disease will develop distant metastases, occurring approximately 15 years after radiation therapy. Approximately 5% to 10% of breast cancers are metastatic at the time of diagnosis. Most incidentally detected lesions are benign however, the reader must consider the potential of these findings to be metastases or additional primary tumors. The detection of these findings during diagnosis and surveillance often results in additional testing, economic burden, and anxiety for the patient. Just as in computed tomography, the issue of the incidental or unexpected finding must be addressed by the reader. 1–6 Although the examination is focused on the breast, portions of the neck, thorax, and upper abdomen are also visualized. It makes valuable contributions in high-risk screening evaluating the extent of disease, positive surgical margins, and response to neoadjuvant chemotherapy as well as distinguishing postoperative scar from recurrent disease. Breast magnetic resonance imaging (MRI) is now an integral part of breast imaging.
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