Role of Breast MR Imaging for Predicting Malignancy of Histologically Borderline Lesions Diagnosed at Core Needle Biopsy: Prospective Evaluation

Pediconi, Federica; Padula, Simona; Dominelli, Valeria; Luciani, M. L.; Telesca, Marianna; Casali, Valeria; Kirchin, Miles A.; Passariello, Roberto; Catalano, Carlo

doi:10.1148/radiol.10100732

Cited by 39 publications

(29 citation statements)

References 54 publications

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“…Typical borderline lesions are atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), lobular carcinoma in situ, papillary lesions, radial sclerosing lesions, fibroepithelial lesions, mucocele like lesions and columnar cell lesions [10].…”

Section: Discussionmentioning

confidence: 99%

“…They were affected by: Invasive Lobular Carcinoma (ILC) (6 subjects), Lobular Carcinoma in Situ (LCIS) (2), Invasive Ductal Carcinoma (IDC) (12), Ductal Carcinoma in Situ (DCIS) (6), phyllodes giant tumor (1), fibroadenomas (13), focalatypical forms of hyperplasia (10). They were all cytological or histological proven.…”

Section: Patients and Protocolmentioning

confidence: 99%

“…The vascularisation of the malignant lesions resulting from neo-vessels, that are the basis of exponential tumour growth, is one of the major reasons that dynamic features of MRI have played a crucial role in breast cancer for a decade [7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Kinetic curve analysis can be performed qualitatively (visual inspection of the curve shape), semi-quantitatively (by means of empirical parameters of signal intensity changes as gradient of the upslope of enhancement curves, maximum signal intensity and wash-out gradient) or quantitatively through pharmacokinetic modelling techniques [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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Can semi-quantitative evaluation of uncertain (type II) time-intensity curves improve diagnosis in breast DCE-MRI?

Fusco¹,

Filice²,

Granata³

et al. 2013

JBiSE

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Objective/Background: Qualitative assessment of uncertain (type II) time-intensity curves (TICs) in breast DCE-MRI is problematic and operator dependent. The aim of this work is to evaluate if a semi-quantitative assessment of uncertain TICs could improve overall diagnostic performance. Methods: In this study 49 lesions from 44 patients were retrospectively analysed. Per each lesion one region-of-interest (ROI)-averaged TIC was qualitatively evaluated by two radiologists in consensus: all the ROIs resulted in type II (uncertain) TIC. The same TICs were semi-quantitatively re-classified on the basis of the difference between the signal intensities of the last-time-point and of the peak: this difference was classified according to two different cut-off ranges (±5% and ±3%). All patients were cytological or histological biopsy proven. Fisher test and McNemar test were performed to evaluate if results were statistically significant (p < 0.05). Results: Using ±5% cut-off 16 TICs were reclassified as type III and 12 as type I while 21 were reclassified again as type II. Using ±3% 22 TICs were reclassified as type III and 16 as type I while 11 were reclassified again as type II. The semi-quantitative classification was compared to the histologicalcytological results: the sensitivity, specificity, positive and negative predictive values obtained with ±3% were 77%, 91%, 91% and 78% respectively while using ±5% were 58%, 96%, 94% and 68% respectively. Using the ±5% cut-off 26/28 (93%) TICs were correctly reclassified while using the ±3% cut-off 34/38 (90%) TICs were correctly reclassified (p < 0.05). Conclusions: Semi-quantitative methods in kinetic curve assessment on DCE-MRI could improve classification of qualitatively uncertain TICs, leading to a more accurate classification of suspicious breast lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Patients and Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Can semi-quantitative evaluation of uncertain (type II) time-intensity curves improve diagnosis in breast DCE-MRI?

Fusco¹,

Filice²,

Granata³

et al. 2013

JBiSE

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“…While the majority of high-risk and borderline lesions may require surgical excision given retrospective data for upgrade rates, close observation may be appropriate in certain selected cases (1,2,4,(6)(7)(8)(9). Furthermore, prospective data are needed to better direct patient care and research focused on immunohistochemical characteristics is needed to advance medicine in breast care.…”

Section: Introductionmentioning

confidence: 99%

Upgraded Malignancy from High-Risk and Borderline Breast Lesions: Immunohistochemical and Clinical Characteristics

Park

Kang

Baek

et al. 2018

J Korean Soc Radiol

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Purpose:The purpose of this study was to investigate the immune-histochemical characteristics of upgraded malignancy from high-risk and borderline breast lesions, and to correlate the upgrade rates with clinical findings. Materials and Methods:We scrutinized image-guided biopsy records retrospectively, and included all women afflicted with high-risk and borderline breast lesions during the period, 2011 to 2015, inclusive. A total of 340 high-risk and borderline lesions were identified by the pathologist in biopsy samples and thereafter, surgical excision and/or image follow-up for at least 24 months was performed. We compared the clinical emanating from both high-risk and borderline lesions, and with and without cancer upgrade. In the instances of lesions with cancer upgrade, histologic and immuohistochemical reviews were performed. Results: Of the 340 high-risk or borderline lesions, 18.8% (64/340) were upgraded. The upgrade rates were higher in patients of more advanced age, larger body habitus and afflicted with atypical ductal hyperplasia rather than with other pathology (p < 0.05). In the lesions with cancer upgrade (n = 64), there was no lymph node metastasis. The estrogen receptor-positive (93.8%), progesterone receptor-positive (87.5%), human epidermal growth factor receptor type 2-negative (90.6%), Ki-67-negative (82.8%), and Luminal A (76.6%) types were seen more frequently. Conclusion: Most upgraded malignancies arising from high-risk and borderline breast lesions were found to be Luminal A-type with good prognostic factors, and the upgrade rates correlated with clinical characteristics.

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Comparison of gadobenate dimeglumine-enhanced breast MRI and gadopentetate dimeglumine-enhanced breast MRI with mammography and ultrasound for the detection of breast cancer

Gilbert

Bosch

Petrillo

et al. 2013

J. Magn. Reson. Imaging

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Role of Breast MR Imaging for Predicting Malignancy of Histologically Borderline Lesions Diagnosed at Core Needle Biopsy: Prospective Evaluation

Abstract: Breast MR imaging can improve the evaluation of lesions classified as borderline at CNB. In cases of nonsuspicious enhancement or no enhancement at breast MR imaging, follow-up rather than surgical biopsy might be performed.

Cited by 39 publications

References 54 publications

Can semi-quantitative evaluation of uncertain (type II) time-intensity curves improve diagnosis in breast DCE-MRI?

Can semi-quantitative evaluation of uncertain (type II) time-intensity curves improve diagnosis in breast DCE-MRI?

Upgraded Malignancy from High-Risk and Borderline Breast Lesions: Immunohistochemical and Clinical Characteristics

Comparison of gadobenate dimeglumine-enhanced breast MRI and gadopentetate dimeglumine-enhanced breast MRI with mammography and ultrasound for the detection of breast cancer

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