• ABSTRACT OF THE STUDY.
• STEP 1 : ARE THE RESULTS OF THE STUDY VALID ?
• STEP 2 : WHAT WERE THE RESULTS ?
• STEP 3 : APPLICABILITY OF THE RESULTS ?
ABSTRACT OF THE STUDY
• BACKGROUND : The goal of the study to detect the recurrence breast cancer
( 1% to 2%) after local excision and radio therapy by
Dynamic contrast-enhanced magnetic resonance
imaging of the breast.
Numbers of patients were 105 women with median age of 58 (50 to 65 years).
All the patients during breast conserving therapy for cancer and recruited
the follow up breast clinics.
The patients underwent a single dynamic MR of the breast routinely in period
1 to 2 years following treatment or recurrent was suspected.
If there are suspicion of recurrence on MR, a biopsy will performed it.
policy to review the patients every 3 months for 1 year and 6 months for 2 year.
Clinical examination is performed at every visit and mammogram every year
by consultant breast radiology.
• RESULT : breast MRI was performed a median of 1.3 years following surgical
and 1 year following completion of adjuvant radiotherapy.
16 biopsies were performed and nine recurrences were confirmed
• DISCUSSION : Dynamic contrast-enhanced MRI of the breast To detectied cancer
was reported 1998.
MRI improve to be able to detect microcalcification and become
good image resolution by breast coils and paramagnetic contrast
Combined clinical examination and mammography are as sensitive
as dedicated dynamic MR. But the MRI high cost than
mammography and clinical examination .
STEP 1 : ARE THE RESULTS OF THE STUDY VALID ?
• Was the diagnostic test evaluated in a
representative spectrum of patients ( like those in
whom it would be used in practice) ?
Was the reference standard applied regardless of the index test
Was there an independent, blind comparison between the index
test and an appropriate reference (GOLD) standard of diagnosis ?
The author did NOT show any blind comparison between clinical
examination ,MAMOGRAPHY AND MRI