PURPOSE: To evaluate the diagnostic value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for patients with atypical ductal hyperplasia (ADH) in predicting malignant upgrade. MATERIALS AND METHODS: 3T DCE-MRI was performed for 17 patients with ADH (median age 52, range 42-76) proven by stereotactic biopsy (n = 15), and ultrasound-guided biopsy (n = 2) from January 2011 to April 2015. All patients underwent surgical excision after the MRI. Two radiologists prospectively reviewed the MRI to determine the presence or absence of suspicious findings at the site of biopsy, and evaluated the MR features of any lesion present according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon. MRI findings and clinical information were correlated with the final surgical pathology by multivariate analysis. RESULTS: Nine of 17 lesions were upgraded to malignancy. MRI demonstrated suspicious nonmass enhancement (NME) at the site of biopsy in all upgraded patients. The median size was 19.5 mm (range, 9-44 mm). In the eight patients without upgrade, no enhancement (n = 2), linear enhancement along the biopsy track (n = 4), thin rim enhancement around hematoma (n = 1), and a focal NME (n = 1) were seen. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI findings were 100, 87.5, 90, and 100%, respectively. Multivariate analysis revealed that the presence of suspicious enhancement on MRI was the most significant predictor of upgrade to malignancy (P = 0.0006) CONCLUSION: Our study revealed a high NPV of DCE-MRI for patients with ADH in terms of malignant upgrade at subsequent surgery. This suggests that patients with ADH without suspicious enhancement on DCE-MRI might be followed with DCE-MRI rather than undergoing surgical excision. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1738-1747.
PURPOSE: To evaluate the diagnostic value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for patients with atypical ductal hyperplasia (ADH) in predicting malignant upgrade. MATERIALS AND METHODS: 3T DCE-MRI was performed for 17 patients with ADH (median age 52, range 42-76) proven by stereotactic biopsy (n = 15), and ultrasound-guided biopsy (n = 2) from January 2011 to April 2015. All patients underwent surgical excision after the MRI. Two radiologists prospectively reviewed the MRI to determine the presence or absence of suspicious findings at the site of biopsy, and evaluated the MR features of any lesion present according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon. MRI findings and clinical information were correlated with the final surgical pathology by multivariate analysis. RESULTS: Nine of 17 lesions were upgraded to malignancy. MRI demonstrated suspicious nonmass enhancement (NME) at the site of biopsy in all upgraded patients. The median size was 19.5 mm (range, 9-44 mm). In the eight patients without upgrade, no enhancement (n = 2), linear enhancement along the biopsy track (n = 4), thin rim enhancement around hematoma (n = 1), and a focal NME (n = 1) were seen. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI findings were 100, 87.5, 90, and 100%, respectively. Multivariate analysis revealed that the presence of suspicious enhancement on MRI was the most significant predictor of upgrade to malignancy (P = 0.0006) CONCLUSION: Our study revealed a high NPV of DCE-MRI for patients with ADH in terms of malignant upgrade at subsequent surgery. This suggests that patients with ADH without suspicious enhancement on DCE-MRI might be followed with DCE-MRI rather than undergoing surgical excision. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1738-1747.
Authors: Christiane K Kuhl; Simone Schrading; Heribert B Bieling; Eva Wardelmann; Claudia C Leutner; Roy Koenig; Walther Kuhn; Hans H Schild Journal: Lancet Date: 2007-08-11 Impact factor: 79.321
Authors: L F Brown; A J Guidi; S J Schnitt; L Van De Water; M L Iruela-Arispe; T K Yeo; K Tognazzi; H F Dvorak Journal: Clin Cancer Res Date: 1999-05 Impact factor: 12.531
Authors: Wendie A Berg; Lorena Gutierrez; Moriel S NessAiver; W Bradford Carter; Mythreyi Bhargavan; Rebecca S Lewis; Olga B Ioffe Journal: Radiology Date: 2004-10-14 Impact factor: 11.105
Authors: Nour Sneige; Sung C Lim; Gary J Whitman; Savitri Krishnamurthy; Aysegul A Sahin; Terry L Smith; Carol B Stelling Journal: Am J Clin Pathol Date: 2003-02 Impact factor: 2.493
Authors: David J Winchester; Joel R Bernstein; Jan M Jeske; Mary H Nicholson; Elizabeth A Hahn; Robert A Goldschmidt; William G Watkin; Stephen F Sener; Malcolm B Bilimoria; Ermilio Barrera; David P Winchester Journal: Arch Surg Date: 2003-06
Authors: Simukayi Mutasa; Peter Chang; John Nemer; Eduardo Pascual Van Sant; Mary Sun; Alison McIlvride; Maham Siddique; Richard Ha Journal: Clin Breast Cancer Date: 2020-06-07 Impact factor: 3.225
Authors: Marco Lucioni; Chiara Rossi; Pascal Lomoro; Francesco Ballati; Marianna Fanizza; Alberta Ferrari; Carlos A Garcia-Etienne; Emanuela Boveri; Giulia Meloni; Maria Grazia Sommaruga; Elisa Ferraris; Angioletta Lasagna; Elisabetta Bonzano; Marco Paulli; Adele Sgarella; Giuseppe Di Giulio Journal: Eur Radiol Date: 2020-08-20 Impact factor: 5.315
Authors: Roberto Lo Gullo; Kerri Vincenti; Carolina Rossi Saccarelli; Peter Gibbs; Michael J Fox; Isaac Daimiel; Danny F Martinez; Maxine S Jochelson; Elizabeth A Morris; Jeffrey S Reiner; Katja Pinker Journal: Breast Cancer Res Treat Date: 2021-01-20 Impact factor: 4.872