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The utility of breast MRI as a problem-solving tool
Edwin J Yau1, Robert L Gutierrez, Wendy B DeMartini
1Department of Radiology, University of Washington Medical Center, Seattle, WA, USA.
The Breast Journal
|April 12, 2011
Summary
Problem-solving breast magnetic resonance imaging (MRI) rarely finds occult cancer. This study suggests judicious use of breast MRI for problem-solving until its benefits are clearer.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Breast magnetic resonance imaging (MRI) is a common problem-solving tool.
- The clinical utility of breast MRI for problem-solving remains uncertain.
Purpose of the Study:
- To evaluate the effectiveness of breast MRI as a problem-solving tool in diagnosing breast cancer.
- To assess the outcomes of breast MRI examinations performed for problem-solving indications.
Main Methods:
- Retrospective review of 3001 breast MRI examinations from January 2003 to June 2007.
- Analysis of clinical presentation, mammography, ultrasound findings, and pathology outcomes.
- Determination of benign versus malignant outcomes via biopsy or 12-month follow-up and tumor registry linkage.
Main Results:
- Problem-solving was the indication for 7% (204/3001) of examinations.
- MRI led to biopsy recommendations in 21% (42/204) of cases.
- 14 cancers were diagnosed; 79% (11/14) had suspicious findings on prior mammography or ultrasound. MRI alone detected one incidental cancer. Two cancers were found with suspicious nipple discharge and negative conventional imaging. One false-negative MRI occurred.
Conclusions:
- Problem-solving breast MRI infrequently identifies occult cancers.
- Breast MRI can be falsely negative in patients with suspicious mammography or ultrasound findings.
- Judicious use of problem-solving breast MRI is recommended pending clarification of its benefits and risks.
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