Breast microcalcifications studied with 3D contrast-enhanced high-field magnetic resonance imaging: more accuracy in the diagnosis of breast cancer.
OBJECTIVE
To evaluate the reliability of magnetic resonance imaging (MRI) performed with three-dimensional (3D) sequences in mammographically detected breast microcalcifications.


METHODS
During an 8-month period, a group of 28 patients with mammographically detected microcalcifications suspicious for malignancy underwent MRI. Their ages ranged from 33 to 65 years. Examinations were performed with a 1.5 Tesia MR unit and a 3D T1 weighted sequence. Images were interpreted on the basis of morphologic parameters and dynamic behavior in the uptake of contrast medium (Gd-DTPA). Histologic findings were considered as the gold reference.


RESULTS
Histologic analysis revealed invasive carcinoma in 7 patients, 3 of which were associated with foci of lobular carcinoma in situ. Intraductal carcinoma was diagnosed in 8 patients, 1 of which was associated with a tubular carcinoma. Benign lesions accounted for 13 patients. All the neoplastic conditions showed enhancement on MR images (sensitivity, 100%), whereas early and intense enhancement was noted in 5 of 13 benign lesions (specificity, 61%). The positive predictive value was 75% and negative predictive value, 100%.


CONCLUSIONS
Although an overlap in the enhancement behavior of malignant and some benign lesions is clearly evident, a careful interpretation of MR images is helpful in detecting and mainly ruling out breast cancer combined with mammographically suspicious microcalcifications.
Unit of Diagnostic Radiology A, National Cancer Research, Milan, Italy. trecate@istitutotumori.mi.it
Giovanna
G
Trecate
John David Tesoro
JD
Tess
Daniele
D
Vergnaghi
Silvana
S
Bergonzi
Tiziana
T
De Simone
Gabriella
G
Mariani
Renato
R
Musumeci
D000328:Adult; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002114:Calcinosis / Q000175:diagnosis*; D002277:Carcinoma / Q000175:diagnosis; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D013997:Time Factors
D003287:Contrast Media; D019786:Gadolinium DTPA