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Journals / Kırıkkale Üniversitesi Tıp Fakültesi Dergisi / 2026 / Cilt: 28 Sayı: 2

THE IMPACT OF MAGNETIC RESONANCE IMAGING ON BI-RADS CLASSIFICATION AND MALIGNANCY PREDICTION IN ULTRASOUND-DETECTED NON-MASS BREAST LESION

Ultrasonografide Saptanan Kitlesel Olmayan Meme Lezyonlarında Manyetik Rezonans Görüntülemenin BI-RADS Sınıflandırmasına Etkisi ve Malignite Öngörüsüne Katkısı

Seçil Gündoğdu(Department of Radiology, Ankara Bilkent City Hospital, ANKARA, TÜRKIYE)0000-0002-6254-3022
Eda Elverici(Department of Radiology, Faculty of Medicine, University of Health Sciences, Ankara, Türkiye)0000-0002-1539-5047
Leman Günbey Karabekmez(Department of Radiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, ANKARA, TURKIYE)0000-0001-9862-0192
Pelin Zeynep Bekin Sarıkaya(Department of Radiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, ANKARA, TURKIYE)0000-0001-9588-6702
Pages
278–283
Publication Date
2026-08-12
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Magnetic resonance imaging -driven downgrade appears safe and may help avoid unnecessary biopsies in selected cases.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: To assess the contribution of magnetic resonance imaging to Breast Imaging Reporting and Data System (BI-RADS) reclassification and biopsy decision making in patients with non-mass breast lesions identified on ultrasound.
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Key Findings & Data:Material and Methods: This retrospective study included 392 patients who underwent breast magnetic resonance imaging following the identification of non-mass breast lesions on ultrasound; 135 had histopathologic verification and were analyzed.
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Conclusion & Impact:Magnetic resonance imaging -driven downgrade appears safe and may help avoid unnecessary biopsies in selected cases.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Kitlesel olmayan lezyon · BI-RADS · manyetik rezonans görüntüleme

Abstract

Objective: To assess the contribution of magnetic resonance imaging to Breast Imaging Reporting and Data System (BI-RADS) reclassification and biopsy decision making in patients with non-mass breast lesions identified on ultrasound. Material and Methods: This retrospective study included 392 patients who underwent breast magnetic resonance imaging following the identification of non-mass breast lesions on ultrasound; 135 had histopathologic verification and were analyzed. BI-RADS categories on ultrasound and magnetic resonance imaging were compared, and reclassification patterns were defined as upgrade (ultrasound <4 to magnetic resonance imaging ≥4), downgrade (ultrasound ≥4 to magnetic resonance imaging <4), or stable. Diagnostic accuracy metrics were calculated using BI-RADS ≥4 as the threshold for clinically significant disease. Results: Among 135 patients with pathology, of the lesions 64.4% were benign, 5.9% were high-risk, and 29.6% were malignant. Using BI-RADS ≥4, magnetic resonance imaging demonstrated higher sensitivity and negative predictive value (95.5% and 90.0%) than ultrasound (61.4% and 77.9%) but substantially reduced specificity (21.2% vs. 70.6%). Magnetic resonance imaging upgraded 48.8% of lesions and downgraded 4.7%. High-risk/malignant disease was detected in 23.8% of upgraded lesions, while all downgraded lesions were benign. Conclusion: Magnetic resonance imaging meaningfully influences BI-RADS reclassification in non-mass breast lesions by improving lesion exclusion confidence but at the cost of lower specificity and reduced biopsy yield. Magnetic resonance imaging -driven downgrade appears safe and may help avoid unnecessary biopsies in selected cases.

Özet

Amaç: Ultrasonografide kitlesel olmayan meme lezyonu saptanan hastalarda manyetik rezonans görüntülemenin Breast Imaging Reporting and Data System (BI-RADS) yeniden sınıflandırma sürecine ve biyopsi gerekliliğine etkisini değerlendirmek. Gereç ve Yöntemler: Ultrasonografide kitlesel olmayan lezyon saptanan ve ardından manyetik rezonans görüntüleme yapılan toplam 392 hasta incelendi; histopatolojik doğrulaması bulunan 135 hasta analize dahil edildi. Ultrason ve manyetik rezonans görüntüleme (BI-RADS) kategorileri karşılaştırıldı ve yeniden sınıflandırma (kategori yükselmesi, kategori düşmesi veya stabil olarak) yapıldı. BI-RADS ≥4 klinik anlamlı hastalık eşiği olarak kabul edilerek tanısal doğruluk ölçütleri hesaplandı. Bulgular: Patoloji doğrulaması olan hastalarda lezyonların %64,4’ü benign, %5,9’u yüksek riskli ve %29,6’sı malign bulundu. BI-RADS ≥4 eşik değeri kullanıldığında manyetik rezonans görüntüleme duyarlılık ve negatif prediktif değer açısından ultrasondan daha yüksek performans gösterdi (%95,5 ve %90,0), ancak özgüllük belirgin şekilde düşüktü (%21,2). Manyetik rezonans görüntüleme, olguların %48,8’inin kategorisini yükseltirken, %4,7’sini düşürdü. Kategorisi yükselen olguların %23,8’i yüksek riskli/malign iken, kategorisi düşürülen tüm olgular benign idi. Sonuç: Manyetik rezonans görüntüleme, kitlesel olmayan lezyonlarda BI-RADS yeniden sınıflandırmayı anlamlı ölçüde etkilemekte ve maligniteyi dışlamada yüksek tanısal güven sağlamaktadır. Bununla birlikte, spesifitedeki düşüş nedeniyle biyopsi veriminde belirgin iyileşme sağlamamakta; kategorisi düşen olgularda gereksiz biyopsileri güvenle azaltma potansiyeli sunmaktadır.

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Cite This Article

Gündoğdu, S., Elverici, E., Karabekmez, L. G., Sarıkaya, P. Z. B. (2026). THE IMPACT OF MAGNETIC RESONANCE IMAGING ON BI-RADS CLASSIFICATION AND MALIGNANCY PREDICTION IN ULTRASOUND-DETECTED NON-MASS BREAST LESION. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, Cilt: 28 Sayı: 2, 278–283. https://doi.org/10.24938/kutfd.1896353

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