MR imaging of mammographically detected clustered microcalcifications: is there any value?

To assess the value of dynamic magnetic resonance (MR) imaging in patients with mammographically detected suspicious microcalcifications.

Sixty-three patients (age range, 31-84 years; mean age, 56 years) with mammographically suspicious clustered microcalcifications underwent dynamic MR imaging of the breast before surgical biopsy. MR imaging was performed with a 1.5-T unit and a two-dimensional fast low-angle shot sequence with a flip angle of 80 degrees. Thirty-two axial sections, 4 mm thick and without interval gaps, were acquired before and five times after administration of gadopentetate dimeglumine (dose, 0.1 mmol per kilogram of bodyweight). Histologic findings were used as the standard of reference. Any effect of MR imaging on surgical management was noted.

Biopsy findings verified five patients with T1 invasive carcinomas, 33 with ductal carcinomas in situ, 13 with proliferative fibrocystic disease, eight with nonproliferative fibrocystic disease, and four with sclerosing adenosis. Contrast material-enhanced dynamic MR imaging had a sensitivity of 45%, a specificity of 72%, and an overall accuracy of 56% in differentiating benign from malignant microcalcifications. All invasive tumors were detected with MR imaging. In no case was surgical management altered by MR imaging findings.

MR imaging of the breast is not reliable in differentiation of benign from malignant breast disease in mammographically suspicious clustered microcalcifications and has no effect on treatment.