Background: Diffusion-weighted MRI is a fast, unenhanced modality that shows promise in identifying mammographically occult malignancy and warrants further investigation as an alternative supplemental breast cancer screening tool. Aim of study: To estimate the diagnostic accuracy of diffusion wighted imaging and apparent diffusion coeffient (ADC) value in the differentiation between benign and malignant breast lesions, and to obtain a cutoff ADC value between benign and malignant breast lesions along with histopathological correlation. Materials and Methods: A prospective study of 56 patients with present with breast mass who examined at 1.5 tesla MRI & proved by histopathology. ADC value were a quired at b values of 0, 600, 850 s/mm² after identification of ROI (Region of interest) placement. ADC value with histopathology correlation was analyzed. Results: From total 56 lesions, 24 lesions were histologically malignant and 32 were histologically benign. With an ADC cut-off value of 1.31 × 10−3 mm2/s for malignant lesions, a sensitivity of 100% and specificity of 72.1% was obtained. The false-postive lesions were one intraductal papilloma & 3 abcesses in which a low ADC value was obtained. Purely DCIS (Ductal carcinoma in situ) lesions presenting as non-mass-like enhancement had a high ADC value of 1.2-1.3 × 10−3 mm2/s, thereby decreasing specificity. Conclusion: Diffusion-weighted Imaging is a functionl quantitative assessment by ADC value, may act as an efficient tool in increasing the diagnostic accuracy and specificity of breast MRI in the characterization of different breast lesions.

Background: To determine whether solid breast masses with benign sonographic features have less than 2% incidence of malignancy, allowing management by follow up instead of biopsy. Patients and Methods: Sonography reports of solid breast masses from February 2021 to the end of February 2022 in Al-Yarmouk teaching hospital, prospectively classified as probably benign (BIRAD III) or low suspicion (BIRAD IVa) were reviewed .The BIRADS categories were correlated with outcome data and tissue diagnosis. Results: The study population included 136 lesions in 100 patients (mean age 36.78 years, range 11-79 years). A total of 63 lesions were prospectively classified as BIRAD III and 73 lesions as BIRAD IVa. A total of 133 lesions were proved as benign lesions and only 3 lesions were malignant. All 3 malignancies seen in women older than 50 years. Conclusions: The incidence of malignancy in solid breast lesions classified as BIRAD III was 1.5 % and in BIRAD IVa was 2.7 %. Palpability alone does not considered as features to rise up the BIRAD grade of any breast lesions.