Circumscribed Masses on Breast MRI: Can MRI Features Guide Management?

Area of Science:

• Radiology
• Oncology
• Breast Imaging

Background:

• Management of circumscribed breast masses on MRI relies heavily on data from other imaging modalities.
• Limited MRI-specific data exists for these lesions, necessitating further research.

Purpose of the Study:

• To evaluate clinical and MRI imaging characteristics of malignant circumscribed breast masses.
• To identify imaging features that can help differentiate benign from malignant circumscribed breast masses on MRI.

Main Methods:

• Retrospective review of breast MRIs with circumscribed masses between 2008 and 2020.
• Analysis of clinical and imaging features, including mass shape and dynamic contrast kinetics.
• Statistical assessment using Fisher's exact test and Wilcoxon rank sum test.

Main Results:

• 5.5% of circumscribed masses were malignant.
• Round masses (18.9%) were more frequently malignant than oval masses (1.7%).
• Malignancy rates varied with kinetic patterns: persistent (0%), plateau (8.7%), and washout (16.7%). Oval masses without washout kinetics showed 0% malignancy.

Conclusions:

• Mass shape and dynamic contrast enhancement kinetics are valuable for managing circumscribed breast masses on MRI.
• Oval masses without washout kinetics and circumscribed masses with persistent kinetics demonstrated no malignancies in this cohort.