J Breast Cancer.  2014 Jun;17(2):167-173.

Low Rates of Additional Cancer Detection by Magnetic Resonance Imaging in Newly Diagnosed Breast Cancer Patients Who Undergo Preoperative Mammography and Ultrasonography

• Kim J
• Han W
• Moon HG
• Ahn SK
• Shin HC
• You JM
• Chang JM
• Cho N
• Moon WK
• Park IA
• Noh DY

Abstract

PURPOSE
We evaluated the efficacy of breast magnetic resonance imaging (MRI) for detecting additional malignancies in breast cancer patients newly diagnosed by breast ultrasonography and mammography.
METHODS
We retrospectively reviewed the records of 1,038 breast cancer patients who underwent preoperative mammography, bilateral breast ultrasonography, and subsequent breast MRI between August 2007 and December 2010 at single institution in Korea. MRI-detected additional lesions were defined as those lesions detected by breast MRI that were previously undetected by mammography and ultrasonography and which would otherwise have not been identified.
RESULTS
Among the 1,038 cases, 228 additional lesions (22.0%) and 30 additional malignancies (2.9%) were detected by breast MRI. Of these 228 lesions, 109 were suspected to be malignant (Breast Imaging-Reporting and Data System category 4 or 5) on breast MRI and second-look ultrasonography and 30 were pathologically confirmed to be malignant (13.2%). Of these 30 lesions, 21 were ipsilateral to the main lesion and nine were contralateral. Fourteen lesions were in situ carcinomas and 16 were invasive carcinomas. The positive predictive value of breast MRI was 27.5% (30/109). No clinicopathological factors were significantly associated with additional malignant foci.
CONCLUSION
Breast MRI was useful in detecting additional malignancy in a small number of patients who underwent ultrasonography and mammography.

Keyword

Breast neoplasms; Limit of detection; Magnetic resonance imaging; Ultrasonography

MeSH Terms

Breast
Breast Neoplasms*
Humans
Information Systems
Korea
Limit of Detection
Magnetic Resonance Imaging*
Mammography*
Retrospective Studies
Ultrasonography*
Ultrasonography, Mammary

Figure

• 

  Figure 1 Additional lesions detected by preoperative breast MRI Among the 1,038 patients included in the analysis, MRI detected additional lesions in 228 patients. A total of 109 were suspicious lesions (BI-RADS category 4 or 5) after second-look targeted ultrasound and 30 were confirmed malignancy. MRI=magnetic resonance imaging; SNUH=Seoul National University Hospital; BI-RADS=Breast Imaging-Reporting and Data System; NED=No evidence of disease. *Benign likely: BI-RADS category 3 lesion both in breast MRI and second-look ultrasonography; †Suspicious malignancy: BI-RADS category 4 or higher lesion after second-look ultrasonography including upstaged; ‡Unknown: lesions unidentifiable after second-look ultrasonography; §Pathologic confirmation: all suspicious lesions were surgically excised and pathologic confirmation was done.

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