Shu Tian Chen1, James Covelli2, Satoko Okamoto3, Bruce L Daniel2, Wendy B DeMartini2, Debra M Ikeda2. 1. Department of Diagnostic Radiology, Chang-Gung Memorial Hospital, Chiayi, Taiwan. 2. Department of Radiology, Stanford University School of Medicine, California, United States. 3. Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan.
Abstract
OBJECTIVE: To compare positive predictive values (PPVs) of clumped vs non-clumped (homogenous and heterogeneous) internal enhancement on MRI detected linear non-mass enhancement (NME) on MRI-guided vacuum-assisted breast biopsy (MRI-VABB). METHODS: With IRB (Institutional Review Board) approval, we retrospectively reviewed 598 lesions undergoing MRI-VABB from January 2015 to April 2018 that showed linear NME. We reviewed the electronic medical records for MRI-VABB pathology, any subsequent surgery and clinical follow-up. The X2 test was performed for univariate analysis. RESULTS: There were 120/598 (20%) linear NME MRI-VABB lesions with clumped (52/120, 43%) vs non-clumped (68/120, 57%) internal enhancement, average size 1.8 cm (range 0.6-7.6 cm). On MRI-VABB, cancer was identified in 22/120 (18%) lesions, ductal carcinoma in situ (DCIS) was found in 18/22 (82%) and invasive cancer in 4 (18%). 3/31 (10%) high-risk lesions upgraded to DCIS at surgery, for a total of 25/120 (21%) malignancies. Malignancy was found in 12/52 (23%) clumped lesions and in 13/68 (19%) of non-clumped lesions that showed heterogeneous (5/13, 38%) or homogenous (8/13, 62%) internal enhancement. The PPV of linear NME with clumped internal enhancement (23.1%) was not significantly different from the PPV of non-clumped linear NME (19.1%) (p = 0.597). The PPV of linear NME lesions <1 cm (33.3%) was not significantly different from the PPV of lesions ≥1 cm (18.6%) (p = 0.157). CONCLUSIONS: Linear NME showed malignancy in 21% of our series. Linear NME with clumped or non-clumped internal enhancement patterns, regardless of lesion size, might need to undergo MRI-VABB in appropriate populations. ADVANCES IN KNOWLEDGE: Evaluation of linear NME lesions on breast MRI focuses especially on internal enhancement pattern.
OBJECTIVE: To compare positive predictive values (PPVs) of clumped vs non-clumped (homogenous and heterogeneous) internal enhancement on MRI detected linear non-mass enhancement (NME) on MRI-guided vacuum-assisted breast biopsy (MRI-VABB). METHODS: With IRB (Institutional Review Board) approval, we retrospectively reviewed 598 lesions undergoing MRI-VABB from January 2015 to April 2018 that showed linear NME. We reviewed the electronic medical records for MRI-VABB pathology, any subsequent surgery and clinical follow-up. The X2 test was performed for univariate analysis. RESULTS: There were 120/598 (20%) linear NME MRI-VABB lesions with clumped (52/120, 43%) vs non-clumped (68/120, 57%) internal enhancement, average size 1.8 cm (range 0.6-7.6 cm). On MRI-VABB, cancer was identified in 22/120 (18%) lesions, ductal carcinoma in situ (DCIS) was found in 18/22 (82%) and invasive cancer in 4 (18%). 3/31 (10%) high-risk lesions upgraded to DCIS at surgery, for a total of 25/120 (21%) malignancies. Malignancy was found in 12/52 (23%) clumped lesions and in 13/68 (19%) of non-clumped lesions that showed heterogeneous (5/13, 38%) or homogenous (8/13, 62%) internal enhancement. The PPV of linear NME with clumped internal enhancement (23.1%) was not significantly different from the PPV of non-clumped linear NME (19.1%) (p = 0.597). The PPV of linear NME lesions <1 cm (33.3%) was not significantly different from the PPV of lesions ≥1 cm (18.6%) (p = 0.157). CONCLUSIONS: Linear NME showed malignancy in 21% of our series. Linear NME with clumped or non-clumped internal enhancement patterns, regardless of lesion size, might need to undergo MRI-VABB in appropriate populations. ADVANCES IN KNOWLEDGE: Evaluation of linear NME lesions on breast MRI focuses especially on internal enhancement pattern.
Authors: Heather I Greenwood; Samantha L Heller; Sungheon Kim; Eric E Sigmund; Sara D Shaylor; Linda Moy Journal: Radiographics Date: 2013-10 Impact factor: 5.333
Authors: Jennifer H Menell; Elizabeth A Morris; D David Dershaw; Andrea F Abramson; Edi Brogi; Laura Liberman Journal: Breast J Date: 2005 Nov-Dec Impact factor: 2.431
Authors: Jeong-Ah Kim; Eun Ju Son; Ji Hyun Youk; Eun-Kyung Kim; Min Jung Kim; Jin Young Kwak; Joon Jeong Journal: AJR Am J Roentgenol Date: 2011-06 Impact factor: 3.959
Authors: Laura Liberman; Elizabeth A Morris; Melissa Joo-Young Lee; Jennifer B Kaplan; Linda R LaTrenta; Jennifer H Menell; Andrea F Abramson; Stephen M Dashnaw; Douglas J Ballon; D David Dershaw Journal: AJR Am J Roentgenol Date: 2002-07 Impact factor: 3.959
Authors: Derek L Nguyen; Kelly S Myers; Eniola Oluyemi; Lisa A Mullen; Babita Panigrahi; Joanna Rossi; Emily B Ambinder Journal: J Breast Imaging Date: 2022-06-28
Authors: Eduardo de Faria Castro Fleury; Caio Castro; Mario Sergio Campos do Amaral; Décio Roveda Junior Journal: Breast Cancer (Auckl) Date: 2022-05-16