Breast lesions detected on MR imaging: Features and positive predictive value Journal Article

Authors: Liberman, L.; Morris, E. A.; Lee, M. J. Y.; Kaplan, J. B.; Latrenta, L. R.; Menell, J. H.; Abramson, A. F.; Dashnaw, S. M.; Ballon, D. J.; Dershaw, D. D.
Article Title: Breast lesions detected on MR imaging: Features and positive predictive value
Abstract: OBJECTIVE. The purpose of this study was to analyze features of breast lesions detected on MR imaging that had subsequent biopsy and to determine the positive predictive value (PPV) of these features. MATERIALS AND METHODS. Retrospective review was performed of 100 consecutive solitary MR imaging-detected breast lesions that had MR imaging-guided needle localization and surgical excision. We described lesions, using terms found in a proposed breast MR imaging lexicon. Histologic findings were reviewed. RESULTS. Carcinoma was identified in 25 lesions (25%), including ductal carcinoma in situ (DCIS) in 13 (52%) and infiltrating carcinoma in 12 (48%). Carcinoma was found in 15 (25%) of 60 masses versus 10 (25%) of 40 nonmass lesions; most malignant masses (73%) were infiltrating carcinoma, whereas most malignant nonmass lesions (90%) were DCIS. The features with the highest PPV were spiculated margin (80% carcinoma), rim enhancement (40% carcinoma), and irregular shape (32% carcinoma) for mass lesions and segmental (67% carcinoma) or clumped linear and ductal enhancement (31% carcinoma) for nonmass lesions. Visually assessed kinetic patterns were not significant predictors of carcinoma, but washout was present in 70% of infiltrating carcinomas versus 9% of DCIS lesions (p < 0.01). Carcinoma was present in 17 (19%) of 88 lesions classified as suspicious versus eight (67%) of 12 lesions classified as highly suggestive of malignancy (p = 0.001). CONCLUSION. Among MR imaging-detected breast lesions referred for biopsy, carcinoma was found in 25%, of which half were DCIS. Features with the highest PPV were spiculated margin, rim enhancement, and irregular shape for mass lesions and segmental or clumped linear and ductal enhancement for nonmass lesions. Final assessment categories were significant predictors of carcinoma.
Keywords: adult; aged; middle aged; retrospective studies; major clinical study; nuclear magnetic resonance imaging; magnetic resonance imaging; image analysis; breast neoplasms; prediction; outcome assessment (health care); diagnostic value; biopsy, needle; breast carcinoma; carcinoma; predictive value of tests; humans; human; female; priority journal; article
Journal Title: American Journal of Roentgenology
Volume: 179
Issue: 1
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2002-07-01
Start Page: 171
End Page: 178
Language: English
PUBMED: 12076929
PROVIDER: scopus
Notes: Export Date: 14 November 2014 -- Source: Scopus
Citation Impact
MSK Authors
  1. Jennifer Kaplan
    27 Kaplan
  2. D David Dershaw
    223 Dershaw
  3. Laura Liberman
    172 Liberman
  4. Jennifer Menell
    16 Menell
  5. Elizabeth A Morris
    329 Morris
  6. Douglas J Ballon
    49 Ballon