NONPALPABLE BREAST-TUMORS - DIAGNOSIS WITH CONTRAST-ENHANCED SUBTRACTION DYNAMIC MR-IMAGING

PURPOSE: To determine the accuracy of contrast material-enhanced subtr action dynamic magnetic resonance (MR) imaging in the diagnosis of non palpable breast tumors. MATERIALS AND METHODS: One hundred forty-three patients underwent surgical biopsy of a nonpalpable breast lesion. Th eir mammograms showed microcalcifications (n = 80), opacity (n = 52), architectural distortion (n = 10), or asymmetric density (n = 1). All patients underwent a preoperative gadolinium tetraazacyclododecanetetr aacetic acid-enhanced subtraction dynamic study. Any early contrast en hancement in the breast parenchyma was considered pathologic. RESULTS: At histologic analysis, 27 intraductal carcinomas, 37 invasive carcin omas, and 79 benign lesions were found. Dynamic MR studies showed earl y contrast enhancement in 61 of 64 breast cancers (sensitivity, 95%) a nd in 37 of 79 benign lesions (specificity, 53%). Two invasive lobular carcinomas and one tubular carcinoma showed no early contrast enhance ment. CONCLUSION: Subtraction dynamic MR imaging may be helpful to rul e out malignancy in nonpalpable breast tumors.