Can breast MRI accurately exclude malignancy in mammographic architectural distortion?

Amitai, Yoav; Scaranelo, Anabel M.; Menes, Tehillah S.; Fleming, Rachel; Kulkarni, Supriya; Ghai, Sandeep; Freitas, Vivianne

doi:10.1007/s00330-019-06586-x

Cited by 29 publications

(28 citation statements)

References 31 publications

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“…AD is being increasingly seen with increased utilization of DBT in screening and diagnostic mammography [9,10] because DBT minimizes superimposed tissue and increases conspicuity of lesions such as AD, which may account for 12-45% of missed breast cancers on 2D mammography [9]. Besides malignancy ( Figure 6), radial scars and complex sclerosing lesions also commonly present as AD and are also being more frequently diagnosed with DBT ( Figure 7 [33]. However, 70% of positive MRI examinations in that study were a false positive and yielded benign results.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Malignant Outcomes of Architectural Distortion on Tomosynthesis: A Systematic Review and Meta-Analysis

Choudhery

Johnson

Larson

et al. 2021

American Journal of Roentgenology

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The publication of this Accepted Manuscript is provided to give early visibility to the contents of the article, which will undergo additional copyediting, typesetting, and review before it is published in its final form. During the production process, errors may be discovered that could affect the content of the Accepted Manuscript. All legal disclaimers that apply to the journal pertain. The reader is cautioned to consult the definitive version of record before relying on the contents of this document.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Malignant Outcomes of Architectural Distortion on Tomosynthesis: A Systematic Review and Meta-Analysis

Choudhery

Johnson

Larson

et al. 2021

American Journal of Roentgenology

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“…[58][59][60] Diagnostic Problem-Solving Breast MRI Breast MRI is extremely useful if there is no enhancement as the negative predictive value (NPV) is close to 100%. [61][62][63] Used when mammography or sonography is not sufficient, e.g. questionable architectural distortions; nipple discharge with inconclusive findings; suspicious lesions seen in a single view digital mammography/digital breast tomosynthesis or even when equivocal changes at site of previous surgery (Figure 5) are noted.…”

Section: Diagnostic Breast Mri For Postoperative Assessmentmentioning

confidence: 99%

What’s Hot in Breast MRI

Scaranelo

2021

Can Assoc Radiol J

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Several articles in the literature have demonstrated a promising role for breast MRI techniques that are more economic in total exam time than others when used as supplement to mammography for detection and diagnosis of breast cancer. There are many technical factors that must be considered in the shortened breast MRI protocols to cut down time of standard ones, including using optimal fat suppression, gadolinium-chelates intravascular contrast administrations for dynamic imaging with post processing subtractions and maximum intensity projections (MIP) high spatial and temporal resolution among others. Multiparametric breast MRI that includes both gadolinium-dependent, i.e., dynamic contrast-enhanced (DCE-MRI) and gadolinium-free techniques, i.e., diffusion-weighted/diffusion-tensor magnetic resonance imaging (DWI/DTI) are shown by several investigators that can provide extremely high sensitivity and specificity for detection of breast cancer. This article provides an overview of the proven indications for breast MRI including breast cancer screening for higher than average risk, determining chemotherapy induced tumor response, detecting residual tumor after incomplete surgical excision, detecting occult cancer in patients presenting with axillary node metastasis, detecting residual tumor after incomplete breast cancer surgical excision, detecting cancer when results of conventional imaging are equivocal, as well patients suspicious of having breast implant rupture. Despite having the highest sensitivity for breast cancer detection, there are pitfalls, however, secondary to false positive and false negative contrast enhancement and contrast-free MRI techniques. Awareness of the strengths and limitations of different approaches to obtain state of the art MR images of the breast will facilitate the work-up of patients with suspicious breast lesions.

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“…More recently, Santucci et al [ 34 ], according to these statements, showed that upgrade was often associated with evident contrast-enhanced lesions. In contrast, Amitai et al [ 11 ] found that MRI has low accuracy in differentiating invasive cancer from RS, with positive predictive value of 30%. In conclusion, in most of the cases, a clear-cut distinction of a RS versus invasive cancer is not possible.…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 97%

“…Imaging is crucial for diagnosis of RS, in some cases, found occasionally during routine radiological screening. In the last years, the role of DBT as a screening and diagnostic tool has been demonstrated to help the radiologist detecting mammographic architectural distortions, resulting in an increasing incidence of both carcinoma and RS [11][12][13].…”

Section: Imaging Findingsmentioning

confidence: 99%

Radial Scar: a management dilemma

et al. 2021

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Radial scar (RS) or complex sclerosing lesions (CSL) if > 10 mm is a benign lesion with an increasing incidence of diagnosis (ranging from 0.6 to 3.7%) and represents a challenge both for radiologists and for pathologists. The digital mammography and digital breast tomosynthesis appearances of RS are well documented, according to the literature. On ultrasound, variable aspects can be detected. Magnetic resonance imaging contribution to differential diagnosis with carcinoma is growing. As for the management, a vacuum-assisted biopsy (VAB) with large core is recommended after a percutaneous diagnosis of RS due to potential sampling error. According to the recent International Consensus Conference, a RS/CSL lesion, which is visible on imaging, should undergo therapeutic excision with VAB. Thereafter, surveillance is justified. The aim of this review is to provide a practical guide for the recognition of RS on imaging, illustrating radiological findings according to the most recent literature, and to delineate the management strategies that follow.

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Can breast MRI accurately exclude malignancy in mammographic architectural distortion?

Cited by 29 publications

References 31 publications

Malignant Outcomes of Architectural Distortion on Tomosynthesis: A Systematic Review and Meta-Analysis

Malignant Outcomes of Architectural Distortion on Tomosynthesis: A Systematic Review and Meta-Analysis

What’s Hot in Breast MRI

Radial Scar: a management dilemma

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