MR LESION DETECTION IN A BREAST-CANCER POPULATION

Implementation of MR imaging of the breast as an extension of the exis ting imaging modalities in the diagnosis of breast cancer was evaluate d in a university cancer center. MR imaging of the breast was performe d in 54 patients, in whom the MR results were compared with the triple test (the combination of clinical examination, mammographic evaluatio n, and cytology) and the final histological diagnosis, MR imaging of t he breast depicted 30 of the 33 malignancies (sensitivity, 91%), In tw o of the malignancies, the carcinoma was clinically and mammographical ly occult, For the three patients with a false-negative MRI diagnosis, the conventional mammography showed suspicious clustered microcalcifi cations as a sign of in situ carcinoma. For seven patients, MR imaging of the breast incorrectly suggested the presence of a malignant lesio n (specificity, 67%). To Improve MR specificity, we perform MR-guided ultrasonographic fine-needle aspiration biopsy (FNAB). Although MR ima ging of the breast is a highly sensitive examination, conventional x-r ay mammography remains the most efficient imaging modality in the diag nosis of breast cancer. In our patient population, MR imaging of the b reast had additional value for women with mammographically dense breas t tissue and especially for patients with clinical evidence of breast carcinoma that could not be detected with conventional diagnostic meth ods.