Dynamic Contrast-Enhanced Breast MRI Findings Predictive of Malignancy in MRI-Only Breast Lesions Examined by MR-Guided Biopsy: A Single-Center Experience

Abstract

Aim: It was aimed to investigate the association between dynamic contrast-enhanced magnetic resonance imaging (MRI) findings and malignancy in suspicious MRI-only breast lesions performed by MR-guided biopsy. Material and Method: Between December 2014 and December 2020, 57 suspicious MRI-only lesions were identified. Among these, 46 lesions underwent MR-guided wire localization and excisional biopsy, while 11 underwent MR-guided core biopsy. Clinical data, MRI findings, biopsy results, and information about the MRguided biopsy procedures were collected. The predictive value of MRI findings in determining malignancy was analyzed. Results: According to biopsy results, 14 (24.6%) of the 57 lesions were malignant, and 43 (75.4%) were benign. The malignancy rate was significantly higher in lesions in the lower inner quadrant (55.5%, p=0.040) and those with a washout kinetic curve than those with persistent and plateau curves (p=0.034). Malignancy was detected in 83.3% of the lesions classified as BI-RADS-MRI category 5 versus only 17.6% of those classified as BI-RADS-MRI category 4 (p=0.006). Conclusion: Kinetic curve type and BI-RADS-MRI category were identified as MRI findings predicting the malignancy of lesions assessed by MR-guided biopsy. According to MR-guided biopsy, BI-RADS-MRI category 5 lesions and those with washout kinetic curves were significantly more likely to be malignant.

Keywords

• image-guided biopsy
• magnetic resonance imaging
• breast cancer
• breast imaging reporting and data system

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