Comparative study on MRI Versus X-Ray in detecting Bone Metastasis in Patients with Locally Advanced Breast Carcinoma

Govindaraj, D (2019) Comparative study on MRI Versus X-Ray in detecting Bone Metastasis in Patients with Locally Advanced Breast Carcinoma. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION Carcinoma breast is the second most common mortality causing cancer next to pulmonary carcinoma worldwide. In India, more than one million women are detected with breast cancer every year. Due to robust healthcare detection of breast cancer, there is a shift in focus from detection of breast cancer, towards appropriate management of breast cancer of all stages. Hence, we studied the need for early detection of spine metastasis which is the most common bone spread of breast cancer, by comparing the accuracies of CT Scan and MRI of spine. By this, a patient with LABC is detected with spine metastasis, the patient is considered as stage 4 which changes the management protocol. AIMS AND OBJECTIVES: As the incidence of breast carcinoma is rising, there is increased incidence of patients with metastasis. The metastasis of spine is the most common in breast cancer. As high as 16-20% patients with LABC (locally advanced breast carcinoma) harbor occult spine metastasis and hence there is a need to detect such metastasis in an early stage as it would change the management plan altogether. The cost and non availability of bone scan (scintigraphy), the recent evolution of MRI techniques in detecting metastatic lesion in spine earlier than CT prompted us to reconsider the imaging techniques required for metastatic work up patients with LABC. Here we compare the effectiveness o CT & MRI spine in detecting occult spine metastasis. METHODOLOGY: 64 patients with locally advanced breast cancer who presented to govt rajaji hospital OPD were included for the study after their consent. All the patients were evaluated by CT and MRI spine. There was no expense spent by the patient as the expense or CT and MRI spine is covered under chief minister insurance scheme. It was ensured that all the reports were issued by a single radiologist. RESULTS: Of the 64 patients, 11 patients had occult spine metastasis. Out of the 11, 2 patients were detected by CT spine and MRI SPINE. The other 9 patients were detected by MRI alone. P value = 0.038. The age of the patients with metastasis were between 46-65. All the 2 patients above 65 years had metastasis. P value = 0.72. All the patients with sine metastasis had their primary lump in the upper quadrant. P value =0.001. The lump size had an influence in the metastatic deposits as most patients with spine metastasis had a lump size of > 5cms. p value 0.038. CONCLUSION: Based on our study MRI spine is the preferred choice to investigate occult spine metastasis and should be incorporated in the metastatic work up o patients with LABC.

Item Type: Thesis (Masters)
Uncontrolled Keywords: magnetic resonance imaging, X-Ray, Bone Metastasis, Locally Advanced Breast Carcinoma.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 03 Sep 2019 23:57
Last Modified: 06 Sep 2019 09:21

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