Haydan Smith1, Alison L Chetlen2, Susann Schetter3, Julie Mack3, Meredith Watts3, Junjia Jay Zhu4. 1. Department of Chemistry, Clemson University, Clemson, South Carolina. 2. Department of Radiology, Penn State Hershey Breast Imaging, Penn State Milton S. Hershey Medical Center, EC 008, 30 Hope Drive, Suite 1800, Hershey, PA 17033-0859. Electronic address: achetlen@hmc.psu.edu. 3. Department of Radiology, Penn State Hershey Breast Imaging, Penn State Milton S. Hershey Medical Center, EC 008, 30 Hope Drive, Suite 1800, Hershey, PA 17033-0859. 4. Biostatistics Core, Penn State Hershey Cancer Institute, Hershey, Pennsylvania.
Abstract
RATIONALE AND OBJECTIVES: Magnetic resonance imaging (MRI) characteristics of Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 lesions were evaluated to identify characteristics that may improve the positive predictive value (PPV) of a biopsy. MATERIALS AND METHODS: MRI BI-RADS 4 or 5 breast findings in 101 women who underwent biopsy leading to a diagnosis of cancer within 1 year (PPV3; n = 115 cases) were reviewed. Patient history, lesion morphology, enhancement pattern and kinetics, and T2 characteristics were examined. RESULTS: The PPV3 of all BI-RADS 4 and 5 breast lesions seen on MRI was 22.6% (26 of 115). Excluding lesions with second-look imaging correlates decreased the PPV3 to 11.8% (6/51). Of the MRI-guided biopsies, 20.9% (24 of 115) yielded a high-risk lesion, altering surgical management. MRI lesion type did not significantly affect the PPV3: the PPV3 was 26.3% (15 of 57) for masses, 21.4% (9 of 42) for non mass enhancement (NME) and 12.5% (2 of 16) for suspicious foci. The PPV3 for lesions found on diagnostic MRI in women with newly diagnosed cancer was 30.8% (20 of 65) which was statistically significantly greater compared to a PPV3 of 11.9% (5 of 42) for lesions identified on high-risk screening MRI. CONCLUSIONS: Suspicious MRI findings identified on a second-look examination are more likely malignant than those seen only on MRI. Suspicious MRI findings discovered in patients with concurrent malignancy have a greater PPV3 than those detected on high-risk screening MRIs. However, the type of MRI finding (mass vs. NME vs. foci) does not significantly affect the PPV3 and should not be used as a discriminator for determining biopsy threshold.
RATIONALE AND OBJECTIVES: Magnetic resonance imaging (MRI) characteristics of Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 lesions were evaluated to identify characteristics that may improve the positive predictive value (PPV) of a biopsy. MATERIALS AND METHODS: MRI BI-RADS 4 or 5 breast findings in 101 women who underwent biopsy leading to a diagnosis of cancer within 1 year (PPV3; n = 115 cases) were reviewed. Patient history, lesion morphology, enhancement pattern and kinetics, and T2 characteristics were examined. RESULTS: The PPV3 of all BI-RADS 4 and 5 breast lesions seen on MRI was 22.6% (26 of 115). Excluding lesions with second-look imaging correlates decreased the PPV3 to 11.8% (6/51). Of the MRI-guided biopsies, 20.9% (24 of 115) yielded a high-risk lesion, altering surgical management. MRI lesion type did not significantly affect the PPV3: the PPV3 was 26.3% (15 of 57) for masses, 21.4% (9 of 42) for non mass enhancement (NME) and 12.5% (2 of 16) for suspicious foci. The PPV3 for lesions found on diagnostic MRI in women with newly diagnosed cancer was 30.8% (20 of 65) which was statistically significantly greater compared to a PPV3 of 11.9% (5 of 42) for lesions identified on high-risk screening MRI. CONCLUSIONS: Suspicious MRI findings identified on a second-look examination are more likely malignant than those seen only on MRI. Suspicious MRI findings discovered in patients with concurrent malignancy have a greater PPV3 than those detected on high-risk screening MRIs. However, the type of MRI finding (mass vs. NME vs. foci) does not significantly affect the PPV3 and should not be used as a discriminator for determining biopsy threshold.
Authors: Annie Tang; Caitlin M Cohan; Keith S Hansen; Genna Beattie; Heather I Greenwood; Rita A Mukhtar Journal: Breast Cancer Res Treat Date: 2021-03-27 Impact factor: 4.872
Authors: Ritse M Mann; Corinne Balleyguier; Pascal A Baltzer; Ulrich Bick; Catherine Colin; Eleanor Cornford; Andrew Evans; Eva Fallenberg; Gabor Forrai; Michael H Fuchsjäger; Fiona J Gilbert; Thomas H Helbich; Sylvia H Heywang-Köbrunner; Julia Camps-Herrero; Christiane K Kuhl; Laura Martincich; Federica Pediconi; Pietro Panizza; Luis J Pina; Ruud M Pijnappel; Katja Pinker-Domenig; Per Skaane; Francesco Sardanelli Journal: Eur Radiol Date: 2015-05-23 Impact factor: 5.315
Authors: João Ricardo Maltez de Almeida; André Boechat Gomes; Thomas Pitangueiras Barros; Paulo Eduardo Fahel; Mário de Seixas Rocha Journal: Radiol Bras Date: 2016 May-Jun