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  • Oral presentation
  • Open Access

Positive predictive value of MRI vacuum biopsies in the diagnosis of nonmass-like lesions of the breast

  • 1,
  • 1 and
  • 1
Breast Cancer Research201214 (Suppl 1) :O3

https://doi.org/10.1186/bcr3252

  • Published:

Keywords

  • Mass Lesion
  • Invasive Disease
  • Histology Result
  • Malignant Mass
  • Park Hospital

Objective

To evaluate the positive predictive value of MRI scoring for malignant mass-like (ML) and nonmass-like (NML) lesions based on the BI-RADS descriptors. To identify MRI characteristics of nonmass lesions which predict malignancy for invasive and non-invasive cancers.

Methods

Retrospective analysis of 486 MRI-guided vacuum biopsies performed at Northwick Park Hospital between April 2006 and November 2011. Each lesion was categorised according to BI-RADS lexicon (ML vs. NML lesions) and time-enhancement curves, and given an overall score of MRI 1 to 5 according to overall level of suspicion for malignant disease where MRI 4 and 5 are considered suspicious or diagnostic for malignancy. Biopsy and surgical histology results obtained.

Results

A total of 291 ML and 152 NML lesions, of which there were 150 cancers diagnosed. Positive predictive value of MRI characteristic for malignant mass lesions is 70%. Positive predictive value of MRI characteristic for nonmass lesions is 57%. Segmental enhancement is the most common MRI morphology found in 45% DCIS. No specific features predict for invasive disease in NML lesions. Time-enhancement curves were mainly type 2 (44.6%) and type 3 (52.7%) in malignant ML lesions and unhelpful in predicting malignancy in NML lesions (72% type 2 and 59% type 3 were benign).

Conclusion

No specific BI-RADS feature predicts for invasive disease in NML lesions. Segmental enhancement is the most common MRI appearance for DCIS. Time-enhancement curves are unhelpful in predicting malignancy in NML lesions.

Authors’ Affiliations

(1)
Northwick Park Hospital, Harrow, UK

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