Foci on breast magnetic resonance imaging in high-risk women: cancer or not?

Paola Clauser, Enrico Cassano, Arianna de Nicolò, Anna Rotili, Bernardo Bonanni, Massimo Bazzocchi, Chiara Zuiani

Research output: Contribution to journalArticle

Abstract

Purpose: To assess how frequently foci are identified on MRI in high-risk patients, and their association with malignancy, breast density, and background parenchymal enhancement (BPE). Materials and methods: In this multicentric study, two readers, in consensus, retrospectively reviewed screening breast MRI of 245 high-risk women, performed between 2009 and 2014. Eligible patients had at least two consecutive screening MRI, and a follow-up of at least 1 year after a lesion was first detected; histology was available for all suspicious findings. Breast density, BPE (both using BI-RADS lexicon), presence, and changes at follow-up for foci were evaluated. Clinical history of the patients was reviewed. Chi-square test was used to define significant correlations. Results: 166 women (mean age 43 years), who underwent a median of 4 MRI (range 2–6) during the study period, were included. 68 foci were found in 58 women [34.9 %, 95 % confidence interval (CI) 28.1–42.5 %]. Foci were more frequent in dense breasts (P = 0.079) and with moderate or marked BPE (P <0.001). During follow-up, two foci increased in size (2.9 %, 95 % CI 0.8–10.1 %) and at biopsy, a cancer was found (1 high-grade ductal carcinoma in situ, 1 tubular carcinoma). Breast cancer was diagnosed in the other three cases, not initially appearing as foci, and it was more frequent in women with dense breasts (P = 0.04); no correlation between cancer and BPE was found (P = 0.145). Conclusions: Foci are relatively frequent in screening MRI, and they are usually benign. An increase in size is the most reliable criteria to suspect malignancy.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalRadiologia Medica
DOIs
Publication statusAccepted/In press - May 12 2016

Fingerprint

Breast
Magnetic Resonance Imaging
Neoplasms
Confidence Intervals
Carcinoma, Intraductal, Noninfiltrating
Chi-Square Distribution
Histology
Adenocarcinoma
Breast Neoplasms
Biopsy
Breast Density

Keywords

  • BI-RADS
  • Breast
  • Cancer
  • High-risk
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Foci on breast magnetic resonance imaging in high-risk women : cancer or not? / Clauser, Paola; Cassano, Enrico; de Nicolò, Arianna; Rotili, Anna; Bonanni, Bernardo; Bazzocchi, Massimo; Zuiani, Chiara.

In: Radiologia Medica, 12.05.2016, p. 1-7.

Research output: Contribution to journalArticle

Clauser, Paola ; Cassano, Enrico ; de Nicolò, Arianna ; Rotili, Anna ; Bonanni, Bernardo ; Bazzocchi, Massimo ; Zuiani, Chiara. / Foci on breast magnetic resonance imaging in high-risk women : cancer or not?. In: Radiologia Medica. 2016 ; pp. 1-7.
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title = "Foci on breast magnetic resonance imaging in high-risk women: cancer or not?",
abstract = "Purpose: To assess how frequently foci are identified on MRI in high-risk patients, and their association with malignancy, breast density, and background parenchymal enhancement (BPE). Materials and methods: In this multicentric study, two readers, in consensus, retrospectively reviewed screening breast MRI of 245 high-risk women, performed between 2009 and 2014. Eligible patients had at least two consecutive screening MRI, and a follow-up of at least 1 year after a lesion was first detected; histology was available for all suspicious findings. Breast density, BPE (both using BI-RADS lexicon), presence, and changes at follow-up for foci were evaluated. Clinical history of the patients was reviewed. Chi-square test was used to define significant correlations. Results: 166 women (mean age 43 years), who underwent a median of 4 MRI (range 2–6) during the study period, were included. 68 foci were found in 58 women [34.9 {\%}, 95 {\%} confidence interval (CI) 28.1–42.5 {\%}]. Foci were more frequent in dense breasts (P = 0.079) and with moderate or marked BPE (P <0.001). During follow-up, two foci increased in size (2.9 {\%}, 95 {\%} CI 0.8–10.1 {\%}) and at biopsy, a cancer was found (1 high-grade ductal carcinoma in situ, 1 tubular carcinoma). Breast cancer was diagnosed in the other three cases, not initially appearing as foci, and it was more frequent in women with dense breasts (P = 0.04); no correlation between cancer and BPE was found (P = 0.145). Conclusions: Foci are relatively frequent in screening MRI, and they are usually benign. An increase in size is the most reliable criteria to suspect malignancy.",
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AU - Cassano, Enrico

AU - de Nicolò, Arianna

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AU - Bonanni, Bernardo

AU - Bazzocchi, Massimo

AU - Zuiani, Chiara

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N2 - Purpose: To assess how frequently foci are identified on MRI in high-risk patients, and their association with malignancy, breast density, and background parenchymal enhancement (BPE). Materials and methods: In this multicentric study, two readers, in consensus, retrospectively reviewed screening breast MRI of 245 high-risk women, performed between 2009 and 2014. Eligible patients had at least two consecutive screening MRI, and a follow-up of at least 1 year after a lesion was first detected; histology was available for all suspicious findings. Breast density, BPE (both using BI-RADS lexicon), presence, and changes at follow-up for foci were evaluated. Clinical history of the patients was reviewed. Chi-square test was used to define significant correlations. Results: 166 women (mean age 43 years), who underwent a median of 4 MRI (range 2–6) during the study period, were included. 68 foci were found in 58 women [34.9 %, 95 % confidence interval (CI) 28.1–42.5 %]. Foci were more frequent in dense breasts (P = 0.079) and with moderate or marked BPE (P <0.001). During follow-up, two foci increased in size (2.9 %, 95 % CI 0.8–10.1 %) and at biopsy, a cancer was found (1 high-grade ductal carcinoma in situ, 1 tubular carcinoma). Breast cancer was diagnosed in the other three cases, not initially appearing as foci, and it was more frequent in women with dense breasts (P = 0.04); no correlation between cancer and BPE was found (P = 0.145). Conclusions: Foci are relatively frequent in screening MRI, and they are usually benign. An increase in size is the most reliable criteria to suspect malignancy.

AB - Purpose: To assess how frequently foci are identified on MRI in high-risk patients, and their association with malignancy, breast density, and background parenchymal enhancement (BPE). Materials and methods: In this multicentric study, two readers, in consensus, retrospectively reviewed screening breast MRI of 245 high-risk women, performed between 2009 and 2014. Eligible patients had at least two consecutive screening MRI, and a follow-up of at least 1 year after a lesion was first detected; histology was available for all suspicious findings. Breast density, BPE (both using BI-RADS lexicon), presence, and changes at follow-up for foci were evaluated. Clinical history of the patients was reviewed. Chi-square test was used to define significant correlations. Results: 166 women (mean age 43 years), who underwent a median of 4 MRI (range 2–6) during the study period, were included. 68 foci were found in 58 women [34.9 %, 95 % confidence interval (CI) 28.1–42.5 %]. Foci were more frequent in dense breasts (P = 0.079) and with moderate or marked BPE (P <0.001). During follow-up, two foci increased in size (2.9 %, 95 % CI 0.8–10.1 %) and at biopsy, a cancer was found (1 high-grade ductal carcinoma in situ, 1 tubular carcinoma). Breast cancer was diagnosed in the other three cases, not initially appearing as foci, and it was more frequent in women with dense breasts (P = 0.04); no correlation between cancer and BPE was found (P = 0.145). Conclusions: Foci are relatively frequent in screening MRI, and they are usually benign. An increase in size is the most reliable criteria to suspect malignancy.

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