Gadolinium-enhanced MR angiography of the breast: Is breast cancer associated with ipsilateral higher vascularity?

The aim of this study was to assess a possible association between breast m alignancy and ipsilateral higher vascularity on gadolinium-enhanced MR angi ography. One hundred six patients were examined by dynamic gadolinium-enhan ced 3D MR imaging. Magnetic resonance angiographic views were generated by image subtraction and maximum intensity projection. The study included 85 p atients with unilateral malignant breast neoplasms and 21 with unilateral b enign lesions. Three blinded readers independently reviewed the MR angiogra ms after masking the lesions and the corresponding contralateral sites. The readers were asked to determine whether vascularity was higher on the righ t side, higher on the left side, or equal on both sides. The results were a nalyzed by the Kappa statistic and Pearson's chi-square test. The blood ves sels of the breasts were clearly seen in all cases. There was good agreemen t among the observers (kappa > 0.54) in assessing vascularity on both sides . Breasts harboring malignant neoplasms were found to have a higher vascula rity than the contralateral breasts (p < 0.005). This sign of malignancy ha d a sensitivity of 76.5 %, a specificity of 57 %, and an accuracy of 72.6 % . Blood vessels of the breast can be depicted by MR angiography. Unilateral malignant neoplasms are associated with a higher ipsilateral vascularity. In conjunction with other indications of malignancy on gadolinium-enhanced MR images, a higher ipsilateral vascularity may serve as an additional sign of malignancy.