Is Breast MRI Helpful in the Evaluation of Inconclusive Mammographic Findings?

Moy, Linda; Elias, K.; Patel, Vashali; Lee, Jiyon; Babb, James S.; Toth, Hildegard K.; Mercado, Cecilia L.

doi:10.2214/ajr.08.1229

Cited by 105 publications

(85 citation statements)

References 22 publications

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“…In this regard, breast MRI has been shown to provide a high negative predictive value (NPV) that may help safely exclude a diagnosis of malignancy. [9][10][11][12] In this study, the diagnostic value of breast MRI as well as its ability to decrease unnecessary biopsies has been examined in a group of patients with solid breast lesions who had an indication for biopsy based on ultrasound results.…”

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confidence: 99%

Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

Sarıca¹,

Uluc²

2014

BJR

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Objective: Biopsy has long been the standard approach in Breast Imaging Reporting and Data System® (BI-RADS) 4 or BI-RADS 5 (American College of Radiology, Reston, VA) lesions despite a wide variation in reported incidence of malignancy in BI-RADS 4 lesions. This study examined the diagnostic value of breast MRI as well as its ability to decrease unnecessary biopsies in patients with solid breast lesions who had an indication for biopsy. Methods: In this retrospective study, 277 breast lesions with a documented histological diagnosis as established by ultrasound-guided biopsy were included. All patients were female, and biopsy was performed owing to a BI-RADS score of 4 or 5 on ultrasonography. In addition, all patients had undergone MRI before biopsy. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI in predicting malignancy were calculated.Results: When all lesions were analysed, sensitivity, specificity, NPV and PPV of MRI in detecting malignancy were 94.2%, 56.1%, 90.7% and 68.1%, respectively. When only ultrasonographic BI-RADS 4 lesions are considered, the corresponding figures were as follows: 90.9%, 56.7%, 93.8% and 46.4%, respectively. False-negative rate of MRI for the latter group of lesions was 2.6%. 42% of unnecessary biopsies were avoided in sonographic BI-RADS 4 lesions. Conclusion: Despite promising results obtained in this study, dynamic MRI currently does not seem to be effective in ruling out the need for biopsy in the assessment of sonographic BI-RADS 4 lesions. However, advanced MRI techniques may assist in improving possible benefits of MRI in this patient group.

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confidence: 99%

Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

Sarıca¹,

Uluc²

2014

BJR

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“…A thorough diagnostic evaluation with mammography and US must be undertaken before considering the necessity of MRI (9) . According to the recommendations of the European Society of Breast Cancer Specialists, breast MRI should be performed in radiological centers specialized in conventional breast imaging (mammography and US), percutaneous biopsy and MRI-directed second-look US (10) .…”

Section: Discussionmentioning

confidence: 99%

Indicações de ressonância magnética das mamas em um centro de referência em oncologia

et al. 2011

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Objective: To evaluate and discuss the indications for breast magnetic resonance imaging in an oncology reference center. Materials and Methods: Retrospective study approved by the Committee for Ethics in Research of the institution and developed through a review of patients' records and clinical reports. All the breast magnetic resonance studies performed in the period from July 2008 to July 2009 (n = 529) were included. Results: Mean patients' age was 49 years, ranging from 17 to 86 years. Family history of breast and/or ovarian cancer was present in 162 patients (30.6%). Most common indications for breast magnetic resonance imaging included inconclusive mammographic/sonographic findings (48.8%), evaluation of tumor recurrence/surgical scar after breast surgery (15.1%), disease staging/surgical planning (11.7%) and screening in high-risk patients (8.5%). Conclusion: In spite of inconclusive findings at conventional imaging studies being the most common indication for breast magnetic resonance imaging, there is no evidence in the literature supporting such a conduct. Because of its high sensitivity and high rate of false positive results, magnetic resonance imaging should be appropriately indicated in order to avoid unnecessary procedures. Once such method is appropriately indicated, it may contribute in the decision making process, constituting an essential tool in the assessment of breast lesions. Keywords: Magnetic resonance imaging; Breast neoplasms; Early detection of cancer.Objetivo: Avaliar e discutir as indicações de ressonância magnética das mamas em um centro de referência oncoló-gico. Materiais e Métodos: Estudo retrospectivo, aprovado pelo Comitê de Ética e Pesquisa da instituição, conduzido através da revisão de prontuários e laudos médicos. Foram incluídos todos os exames de ressonância magnética das mamas realizados no período de julho de 2008 a julho de 2009 (n = 529). Resultados: A idade média das pacientes foi de 49 anos, variando de 17 a 86 anos. História familiar de câncer de mama e/ou ovário esteve presente em 162 pacientes (30,6%). As indicações mais comuns de ressonância magnética das mamas foram esclarecimento de achados inconclusivos na mamografia e/ou ultrassom (48,8%), avaliação de recorrência tumoral/cicatriz cirúrgica (15,1%), estadiamento/planejamento cirúrgico (11,7%) e rastreamento de pacientes de alto risco (8,5%). Conclusão: Apesar de achados inconclusivos nos exames convencionais serem a indicação mais comum de ressonância magnética das mamas, não há evidências que justifiquem esta conduta na literatura. Em razão da sua alta sensibilidade e percentual de falso-positivos, este exame deve ser adequadamente indicado, para evitar a realização de procedimentos desnecessários. Se bem indicada, a ressonância magnética pode contribuir para o processo de tomada de decisão e constitui uma ferramenta fundamental na avaliação de lesões mamárias. Unitermos: Imagem por ressonância magnética; Neoplasias da mama; Detecção precoce de câncer. AbstractResumo

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“…For woman under age 30, ultrasound is sufficient to determine whether particular region required biopsy or not but for woman older than 30 year mammogram and ultrasound used together for the diagnosis. MRI of the breast offers valuable information about breast condition that can't be obtained by other image modalities, such as mammography or ultrasound [13]. Dynamic Contrast Enhanced MRI (DCE-MRI) can be used for women with dense breast.…”

Section: Literature Reviewmentioning

confidence: 99%

Identification of Micro-calcification in Mammogram for Breast Cancer Analysis using SVM Classifier

Makwana¹,

Gupta²

2018

IJET

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Breast cancer is most common disease in women of all ages. To identify & confirm the state of tumor in breast cancer diagnosis, patients are undergo biopsy number of times to identify malignancy. Early detection of cancer can save the patient. In this paper a novel approach for automatic segmentation & classification of breast calcification is proposed. The diagnostic test technique for detection of breast condition is very costly & requires human expertise whereas proposed method can help in automatically identifying the disease by comparing the data with the standard database. In proposed method a database has been created to define various stage of breast calcification & testing images are pre-processed to resize, enhance & filtered to remove background noise. Clustering is performed by using k-means clustering algorithm. GLCM is used to extract out statistical feature like area, mean, variance, standard deviation, homogeneity, skewness etc. to classify the state of tumor. SVM classifier is used for the classification using extracted feature. .

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Is Breast MRI Helpful in the Evaluation of Inconclusive Mammographic Findings?

Abstract: We found breast MRI to be a useful adjunctive tool when findings at conventional imaging were equivocal. Strict patient selection criteria should be used because of the high frequency of incidental lesions seen on MR images.

Cited by 105 publications

References 22 publications

Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

Indicações de ressonância magnética das mamas em um centro de referência em oncologia

Identification of Micro-calcification in Mammogram for Breast Cancer Analysis using SVM Classifier

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