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Park, Kim, Moon, Yoon, and Kim: Effect of the Menstrual Cycle on Background Parenchymal Enhancement Observed on Breast MRIs in Korean Women
Breast Radiology

Journal of the Korean Society of Radiology 2015; 73(3): 158-163.

Published online: 1 September 2015

DOI: https://doi.org/10.3348/jksr.2015.73.3.158

Effect of the Menstrual Cycle on Background Parenchymal Enhancement Observed on Breast MRIs in Korean Women

Vivian Youngjean Park, MD, Eun-Kyung Kim, MD, Hee Jung Moon, MD, Jung Hyun Yoon, MD, Min Jung Kim, MD

Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Min Jung Kim, MD. Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel. 82-2-2228-7400, Fax. 82-2-393-3035, mines@yuhs.ac

Received 2 June 2015       Revised 18 June 2015       Accepted 23 June 2015

Copyright © 2015 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effect of the menstrual cycle on background parenchymal enhancement observed on breast MRIs in Korean women, and to suggest an optimal period for scheduling breast MRIs.

Materials and Methods

Between March and December 2012, 214 premenopausal breast cancer patients who underwent breast MRIs for preoperative evaluation were included. Levels of background parenchymal enhancement were retrospectively compared according to the menstrual cycle.

Results

There was no significant difference between levels of background parenchymal enhancement (minimal, mild, moderate, and marked) according to the weeks of the menstrual cycle. However, the 1st and 2nd week of the menstrual cycle showed a significantly higher proportion of patients with minimal background parenchymal enhancement than the 3rd and 4th week of the menstrual cycle (47.0% vs. 32.0%; p = 0.025).

Conclusion

For screening purposes and for the follow-up of Korean breast cancer patients, breast MRIs should be performed during the 1st or 2nd week of the menstrual cycle.

Keywords: Magnetic Resonance Imaging, Breast, Menstrual Cycle, Contrast Media, Screening

Figures and Tables

Fig. 1

A 42-year-old woman with left breast cancer who underwent a preoperative breast MRI during the second week of her menstrual cycle. The first subtraction axial image shows minimal background parenchymal enhancement at her right breast.

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Fig. 2

A 34-year-old women with left breast cancer who underwent a preoperative breast MRI during the third week of her menstrual cycle. The first subtraction axial image shows marked background parenchymal enhancement at her right breast.

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Table 1

Background Parenchymal Enhancement of the 214 Patients on Breast MRI According to Menstrual Cycle

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Background Parenchymal Enhancement Menstrual Cycle
1st Week 2nd Week 3rd Week 4th Week
Minimal (%) 27 (45.8) 28 (48.3) 16 (31.4) 15 (32.6)
Mild (%) 17 (28.8) 19 (32.8) 17 (33.3) 18 (39.1)
Moderate (%) 15 (25.4) 8 (13.8) 15 (29.4) 12 (26.1)
Marked (%) 0 (0) 3 (5.2) 3 (5.9) 1 (2.2)

Percentage of background parenchymal enhancement is shown in parentheses, according to each week of the menstrual cycle.

Table 2

Breast Composition of the 214 Patients According to Background Parenchymal Enhancement on Breast MRI

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Breast Composition Background Parenchymal Enhancement
Minimal Mild Moderate Marked
Scattered fibroglandular (%) 4 (4.6) 1 (1.4) 1 (2.0) 0 (0)
Heterogeneously dense (%) 74 (85.1) 56 (80.0) 43 (86.0) 6 (85.7)
Extremely dense (%) 9 (10.3) 13 (18.6) 6 (12.0) 1 (14.3)

Percentage of breast composition is shown in parentheses, according to each level of background parenchymal enhancement.

Table 3

Comparison of Percentage of Minimal Background Parenchymal Enhancement between the Early Phase (1st and 2nd Weeks) and Late Phase (3rd and 4th Weeks) of the Menstrual Cycle

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Background Parenchymal Enhancement Menstrual Cycle p-Value
1st and 2nd Week 3rd and 4th Week
Minimal (%) 55 (47.0) 31 (32.0) 0.025
Others (mild, moderate, marked) (%) 62 (53.0) 66 (68.0)

Notes

This study was supported by a faculty research grant of Yonsei University College of Medicine for (6-2015-0050).

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