A diagnostic dilemma: New enhancing suspicious findings on breast MRI following neoadjuvant chemotherapy Journal Article
| Authors: | LaRoy, J. R.; Tadros, A. B.; Sevilimedu, V.; Mango, V. L. |
| Article Title: | A diagnostic dilemma: New enhancing suspicious findings on breast MRI following neoadjuvant chemotherapy |
| Abstract: | Objective: Evaluate the incidence and outcome of new enhancing findings on breast MRI after neoadjuvant chemotherapy (NAC). Methods: This IRB-approved retrospective review included women with breast cancer undergoing MRI to evaluate NAC response at our institution from January 1, 1998 to March 3, 2021. Post-NAC MRIs given BI-RADS 4 or 5 with new enhancing findings were identified. Patients were excluded if they lacked pretreatment MRI or insufficient follow-up, or if the finding was a satellite of the primary tumor. Medical records and imaging studies were reviewed to identify patients and to find characteristics and outcomes. Results: Over the study period, 2880 post-NAC breast MRIs were performed. Of 128 post-NAC MRIs given BI-RADS 4 or 5 (4.4%), 35 new suspicious findings were found on 32 MRIs, incidence rate 1.1% (32/2880). Most were characterized as nonmass enhancement (17/35, 49%), followed by mass (11/35, 31%), and then focus (7/35, 20%), with an average maximum dimension of 1.3 cm (range 0.3-7.1 cm). New findings were ipsilateral to the index cancer in 20/35 (57%) of cases. Of the 35 suspicious findings, 22 underwent image-guided biopsy (62%), 1 was surgically excised (3%), 7 underwent mastectomy (20%), 5 were stable or resolved on follow-up (8%), and none were malignant. Thirty-three were benign (94%), and two were benign high-risk lesions (atypical ductal hyperplasia, radial scar) (6%). Conclusion: New suspicious breast MRI findings after NAC are uncommon with a low likelihood of malignancy. Further study is warranted using multi-institutional data for this low incidence finding. © 2023 Society of Breast Imaging. All rights reserved. |
| Keywords: | breast cancer; neoadjuvant chemotherapy; breast mri |
| Journal Title: | Journal of Breast Imaging |
| Volume: | 5 |
| Issue: | 4 |
| ISSN: | 2631-6110 |
| Publisher: | Oxford University Press |
| Date Published: | 2023-07-01 |
| Start Page: | 453 |
| End Page: | 458 |
| Language: | English |
| DOI: | 10.1093/jbi/wbad035 |
| PROVIDER: | scopus |
| PMCID: | PMC11166475 |
| PUBMED: | 38416906 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Victoria Mango -- Source: Scopus |
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