Is biopsy necessary? Role of DCE-MRI in BIRADS-3 lesions

Özet

PURPOSEWe aimed to evaluate BIRADS-3 breast lesions with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and compare with histopathology, and to investigate the effectivenessof breast MRI for follow-up and management.METHODSA total of 84 BIRADS-3 lesions reported by US or mammography and evaluated by DCE-MRI between September 2014 and October 2015 were included in this study. All patients underwentpercutaneous or surgical biopsy for histopathologic diagnosis. Morphologic and kinematic features on MRI were compared with histopathologic results.RESULTSOf the 84 BIRADS-3 breast lesions, 9 (10.7%) had malignant features on DCE-MRI and all wereverified with histopathologic results. DCE-MRI had 96.7% sensitivity, 72% specificity, 92% positive predictive value, and 82.5% negative predictive value. MRI and histopathology results werecorrelated for the diagnosis of malignant lesions. The sensitivity and negative predictive value ofMRI for diagnosis of malignant lesions were both 100%.CONCLUSIONDifferentiation of benign versus malignant lesions was accomplished with 100% accuracy withDCE-MRI. We suggest that DCE-MRI should be an additional diagnostic tool and problem-solvingmodality for BIRADS-3 lesions, particularly in patients with relative risk factors.