Skip to main content

Positive predictive value of MRI vacuum biopsies in the diagnosis of nonmass-like lesions of the breast

Objective

To evaluate the positive predictive value of MRI scoring for malignant mass-like (ML) and nonmass-like (NML) lesions based on the BI-RADS descriptors. To identify MRI characteristics of nonmass lesions which predict malignancy for invasive and non-invasive cancers.

Methods

Retrospective analysis of 486 MRI-guided vacuum biopsies performed at Northwick Park Hospital between April 2006 and November 2011. Each lesion was categorised according to BI-RADS lexicon (ML vs. NML lesions) and time-enhancement curves, and given an overall score of MRI 1 to 5 according to overall level of suspicion for malignant disease where MRI 4 and 5 are considered suspicious or diagnostic for malignancy. Biopsy and surgical histology results obtained.

Results

A total of 291 ML and 152 NML lesions, of which there were 150 cancers diagnosed. Positive predictive value of MRI characteristic for malignant mass lesions is 70%. Positive predictive value of MRI characteristic for nonmass lesions is 57%. Segmental enhancement is the most common MRI morphology found in 45% DCIS. No specific features predict for invasive disease in NML lesions. Time-enhancement curves were mainly type 2 (44.6%) and type 3 (52.7%) in malignant ML lesions and unhelpful in predicting malignancy in NML lesions (72% type 2 and 59% type 3 were benign).

Conclusion

No specific BI-RADS feature predicts for invasive disease in NML lesions. Segmental enhancement is the most common MRI appearance for DCIS. Time-enhancement curves are unhelpful in predicting malignancy in NML lesions.

Author information

Affiliations

Authors

Corresponding author

Correspondence to WL Teh.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Teh, W., Papantoniou, E. & Ng, F. Positive predictive value of MRI vacuum biopsies in the diagnosis of nonmass-like lesions of the breast. Breast Cancer Res 14, O3 (2012). https://0-doi-org.brum.beds.ac.uk/10.1186/bcr3252

Download citation

Keywords

  • Mass Lesion
  • Invasive Disease
  • Histology Result
  • Malignant Mass
  • Park Hospital