Background or Purpose

To quantitatively evaluate breast tumor mobility and shape changes by posture changes using prone and supine magnetic resonance imaging (MRIs)for breast conservation surgery (BCS).

Methods

Thirty one patients who were diagnosed with breast cancer and scheduled to receive neoadjuvant systemic therapy (NST) under the plan for BCS were studied.After MRIscanning on prone position, mDIXONscan on supine position was performed immediately.Based on tumor segmentation,every tumors’ volume and position were evaluated in both positions.The volume change of breast tumor, various kinds of spatial movement in nipple and the bottom center of the sternum origin, and distance from tumor center to the chest wallwere also measured and analyzed.

Results

The mean and standard deviation tumor volumes of prone and supine were 9797.3±9390.6, 9795.5±9413.1 mm³, respectively and no significant difference was found between two positions (p=0.877). The average tumor movement at the nipple origin from prone to supine position was 27.8±3.3mm. Total movement from prone to supine position at the bottom center of the sternumorigin was 63.1±26.2 mm which was strongly correlated with the distance from tumor center to chest wall (r=0.669; p<0.05).

Conclusions

Tumor change from prone to supine position at the nipple origin differs depending on tumor location in the breast, and their average total distances were no more than 30 mm in Asian population. However, prone-to-supine movement of all tumors at the bottom center of the sternum origin tend to move outward from the sagittal centerline of the body on coronal plane, move to the inside of body on sagittal plane and move to the outward and downward closed to the body on axial plane.The results of above might be helpful for surgeons using standard prone position MR image to localize the tumor position in the operating room.

Acknowledgements

We thank Department of breast Surgery,for give us breast cancer patients information of this manuscript.

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