Apparent diffusion coefficient value in breast papillary lesions without atypia at core needle biopsy

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Papillary lesions (PL) require accurate differentiation between benign and atypical/malignant types.
• Core needle biopsy (CNB) is a primary diagnostic tool, but further characterization may be needed.
• Magnetic Resonance Imaging (MRI) offers non-invasive assessment capabilities.

Purpose of the Study:

• To determine if mean apparent diffusion coefficient (ADC) values differ significantly between papillary lesions (PL) without atypia and those with atypical or malignant foci.
• To evaluate if patient age, MRI BI-RADS® descriptors, and assessment categories differ between these PL groups.

Main Methods:

• Retrospective analysis of 122 patients with 122 PLs diagnosed via sonographically guided CNB.
• All patients underwent MRI (STIR, DWI, Dynamic Contrast-Enhanced sequences) prior to surgical excision.
• Histopathological examination of CNB specimens was performed.

Main Results:

• A statistically significant difference in mean ADC values was observed between PLs without atypia and those with atypical/malignant foci (p < 0.0001).
• An optimal ADC threshold of 1.418 × 10^-3 mm²/s was identified to distinguish the groups.
• Mean ADC values ≤ 1.418 × 10^-3 mm²/s predicted atypical/malignant foci with 83.9% sensitivity and 75.8% specificity.
• No significant differences were found in patient age, MRI BI-RADS® descriptors, or assessment categories between the groups.

Conclusions:

• Mean ADC value is an effective tool for differentiating PLs without atypia from those with atypical or malignant foci.
• ADC values can assist in clinical decision-making for managing papillary lesions.
• This imaging biomarker may help refine diagnostic pathways for PLs.