Sensitivity of MRI Versus Mammography for Detecting Foci of Multifocal, Multicentric Breast Cancer in Fatty and Dense Breasts Using the Whole-Breast Pathologic Examination as a Gold Standard

Sardanelli, Francesco; Giuseppetti, Gian Marco; Panizza, Pietro; Bazzocchi, Massimo; Fausto, Alfonso; Simonetti, Giovanni; Lattanzio, Vincenzo; Maschio, Alessandro Del

doi:10.2214/ajr.183.4.1831149

Cited by 410 publications

(231 citation statements)

References 33 publications

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“…However, breast lesions remain difficult to diagnose and characterize, especially in dense fibroglandular breasts. The main advantage of dynamic studies with MRI in the breast is that they can improve the detection and characterization of multiple and/or small lesions (29,30). However, the low specificity of MRI (1-4) remains a problem.…”

Section: Discussionmentioning

confidence: 99%

Quantitative diffusion imaging in breast cancer: A clinical prospective study

Rubesova

Grell

Maertelaer

et al. 2006

Magnetic Resonance Imaging

230

199

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Purpose: To study the correlation between apparent diffusion coefficient (ADC) and pathology in patients with undefined breast lesion, to validate how accurately ADC is related to histology, and to define a threshold value of ADC to distinguish malignant from benign lesions. Materials and Methods:Seventy-eight patients (110 lesions) were referred for positive or dubious findings. Threedimensional fast low-angle shot (3D-FLASH) with contrast injection was applied. EPI diffusion-weighted imaging (DWI) with fat saturation was performed, and ROIs were selected on subtraction 3D-FLASH images before and after contrast injection, and copied on an ADC map. Inter-and intraobserver analyses were performed.Results: At pathology 22 lesions were benign, 65 were malignant, and 23 were excluded. The ADCs of malignant and benign lesions were statistically different. In malignant tumors the ADC was (mean Ϯ SEM) 0.95 Ϯ 0.027 ϫ 10 -3mm 2 /second, and in benign tumors it was 1.51 Ϯ 0.068 ϫ 10 -3 mm 2 /second. According to receiver operating characteristic (ROC) curves, we found a threshold between malignant and benign lesions for highest sensitivity and specificity (both 86%) around 1.13 Ϯ 0.10 ϫ 10 -3 mm 2 /second. For a threshold of 0.95 Ϯ 0.10 ϫ 10 -3 mm 2 /second, specificity was 100% but sensitivity was very low. Inter-and intraobserver studies showed good reproducibility. Conclusion:The ADC may help to differentiate benign and malignant lesions with good specificity, and may increase the overall specificity of breast MRI.

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Section: Discussionmentioning

confidence: 99%

Quantitative diffusion imaging in breast cancer: A clinical prospective study

Rubesova

Grell

Maertelaer

et al. 2006

Magnetic Resonance Imaging

230

199

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“…However, limitations in sensitivity and specificity of mammography remain be well known, including breast with dense parenchyma. Dense breast reduces its sensitivity (Carney et al, 2003;Sardanelli et al, 2004). The research has revealed that the percents of western women with fat breast tissue were higher in 40 years old or older (Stomper et al, 1966).…”

Section: Introductionmentioning

confidence: 99%

Analysis of Mammographic Breast Density in a Group of Screening Chinese Women and Breast Cancer Patients

Liu¹,

Liu²,

Li³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: A dense breast not only reduces the sensitivity of mammography but also is a moderate independent risk factor for breast cancer. The percentage of Western women with fat breast tissue is higher aged 40 years or older. To a certain extent, mammography as a first choice of screening imaging method for Western women of this group is reasonable. Hitherto, the frequency and age distribution of mammographic breast density patterns among Chinese women had not been characterized. The purpose of this study was to investigate the frequency and age distribution of mammographic breast density patterns among a group of Chinese screening women and breast cancer patients in order to provide useful information for age-specific guidelines for breast cancer screening in Chinese women. Methods: A retrospective review of a total of 3,394 screening women between August and December 2009 and 2,527 breast cancer patients between July 2011 and June 2012 was conducted. Descriptive analyses were used to examine the association between age and breast density. The significance of differences of breast density between the screening women and the breast cancer patients was examined using nonparametric tests. Results: There was a significant inverse relationship between age and breast density overall (r=-0.37, p< 0.01). Breast density of the breast cancer patients in the subgroups of 40-49 years old was greater compared with that of the screening women, the same in those aged 50-54 years and in those 55 years old or older, less than in the screening group. Conclusions: With regard to the Chinese women younger than 55 years old, the diagnostic efficiency of breast cancer screening imaging examinations may be potentially improved by combining screening mammography with ultrasound.

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“…Although mammography is the most commonly used imaging modality for breast screening, its effectiveness may be reduced in women with dense breasts and its sensitivity is poor for young women (Moss, 1999;Sardanelli et al, 2004;Berg et al, 2008). Breast cancer has been one of the most common cancers and the fourth-leading cause of cancer death among women in China (Yang et al, 2005;Yang et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Effects of Age, Breast Density and Volume on Breast Cancer Diagnosis: A Retrospective Comparison of Sensitivity of Mammography and Ultrasonography in China's Rural Areas

Wang¹,

Chen²,

Yin³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Purpose: Mammography has been confirmed as the only effective mode to improve the prognosis of patients with breast cancer in Western developed countries, but might not be a good choice in other areas of the world. One of the major challenges in China is to determine an optimal imaging modality for breast cancer screening. This study was designed to clarify the sensitivity of ultrasonography compared with that of mammography in rural China. Methods: We retrospectively studied the sensitivity of mammography and ultrasonography based on 306 breast cancer patients detected by the program of "screening for cervical cancer and breast cancer" performed in Chinese rural areas between January 2009 and December 2011, and analyzed the effects of age, breast density and volume on the sensitivity. Results: Stratified analysis showed that the sensitivity of breast ultrasonography was significantly higher than that of mammography in premenopausal patients (81.4% vs. 61.1%, p=0.02), in women ≤ 55 years of age (82.2% vs. 63.4%, p<0.01), in the high breast density group (American College of Radiology [ACR] levels 3-4) (85.9% vs. 60.6%, p<0.01) and in the small breast volume group (≤400 ml) (87.1% vs. 66.7%, p<0.01). Age had a significant effect on sensitivity of mammography (breast density and volume-adjusted odds ratio, 6.39; 95% confidence interval, 2.8-14.4 in age group > 55 compared to age group ≤ 45), but not that of ultrasonography. Neither breast density nor volume had significant effect on sensitivity of mammography or ultrasonography. Conclusions: Ultrasonography is more sensitive than mammography in detecting breast cancer in women under 55 year-old Chinese, especially in those with high-density and relatively small breasts.

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Sensitivity of MRI Versus Mammography for Detecting Foci of Multifocal, Multicentric Breast Cancer in Fatty and Dense Breasts Using the Whole-Breast Pathologic Examination as a Gold Standard

Abstract: MRI was more sensitive than mammography for the detection of multiple malignant foci in fibroglandular or dense breasts. Mammography missed larger and more invasive cancer foci than MRI. A relatively low PPV was a problem for both techniques.

Cited by 410 publications

References 33 publications

Quantitative diffusion imaging in breast cancer: A clinical prospective study

Quantitative diffusion imaging in breast cancer: A clinical prospective study

Analysis of Mammographic Breast Density in a Group of Screening Chinese Women and Breast Cancer Patients

Effects of Age, Breast Density and Volume on Breast Cancer Diagnosis: A Retrospective Comparison of Sensitivity of Mammography and Ultrasonography in China's Rural Areas

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