E-ISSN 1305-3612
Breast Imaging - Original Article
Problem-solving breast MRI: useful or a source of new problems?
1 Department of Radiology, Adnan Menderes University School of Medicine, Aydın, Turkey  
2 Department of Pathology, Adnan Menderes University School of Medicine, Aydın, Turkey  
3 Department of Breast-Endocrine Surgery, Güven Hospital Breast Center, Ankara, Turkey  
Diagn Interv Radiol ; : -

Abstract

 

PURPOSE: To evaluate the findings and results from breast MRI examinations performed for problem-solving purposes due to inconclusive conventional imaging findings.

 

METHODS: Approval was obtained from the institution's ethics committee. Imaging findings, biopsy and follow-up results were retrospectively evaluated for breast MRI performed for problem-solving purposes at our department between January 2011 and December 2016 for cases whose mammography, tomosynthesis or ultrasound findings were inconclusive. 

 

RESULTS: Lesions were identified in 414 of 986 problem-solving MRI examinations, and 13.3% of these lesions were diagnosed as malignant. An additional 124 lesions were found by MRI; 9.7% of these lesions were diagnosed as malignant. MRI produced false-negative results in 4 cases. In cases whose conventional imaging methods yielded indefinite results, the sensitivity, specificity, NPV, and PPV of MRI were found to be 96.3%, 83%, 99.3%, and 46.5%, respectively. For the additional lesions identified, the sensitivity, specificity, NPV, and PPV of MRI were found to be 91.7%, 69%, 98.7%, and 24%, respectively.

 

CONCLUSION: Breast MRI is a reliable problem-solving method for excluding malignancy that cannot be confirmed by conventional imaging. In such cases, additional findings from MRI may help identify new cancers that cannot be detected with conventional methods. However, its moderately low specificity which may cause unnecessary biopsies, follow-ups and anxiety to patients. 

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