Problem-solving breast MRI: useful or a source of new problems?

Özet

PURPOSEWe aimed to evaluate the findings and results from breast magnetic resonance imaging (MRI)examinations performed for problem-solving purposes due to inconclusive conventional imagingfindings.METHODSImaging findings, biopsy and follow-up results were retrospectively evaluated for breast MRI performedfor problem-solving purposes at our department between January 2011 and December2016 for cases whose mammography, tomosynthesis, or ultrasonography findings were inconclusive.RESULTSLesions were identified in 414 of 986 problem-solving MRI examinations, and 13.3% of theselesions were diagnosed as malignant. A total of 124 lesions were additionally found by MRI, and9.7% of these lesions were diagnosed as malignant. MRI produced false-negative results in fourcases. In cases whose conventional imaging methods yielded indefinite results, the sensitivity,specificity, negative and positive predictive values of MRI were found to be 96.3%, 83%, 99.3%,and 46.5%, respectively. For the additional lesions identified, the sensitivity, specificity, negativeand positive predictive values of MRI were found to be 91.7%, 69%, 98.7%, and 24%, respectively.CONCLUSIONBreast MRI is a reliable problem-solving method for excluding malignancy that cannot be confirmedby conventional imaging. In such cases, additional findings from MRI may help identifynew cancers that cannot be detected with conventional methods. However, it has moderatelylow specificity which may cause unnecessary biopsies, follow-ups, and anxiety to patients.