Detection and localization of occult lesions using breast magnetic resonance imaging: initial experience in a community hospital.
OBJECTIVE
To evaluate the outcome of diagnostic breast MR imaging followed by MR guided needle localization for mammographically and sonographically occult breast lesions in a community-based hospital.


METHODS
Records of the initial 50 consecutive patients who underwent MR guided needle localizations at our institution from November 2001 to January 2003 were reviewed. Sixty-two lesions were localized by MR and were mammographically and sonographically occult. Pathology following excision was reviewed and correlated with the MR findings.


RESULTS
Cancer was present in 15 % (9/62) of lesions or 18 % (9/50) of the women localized. Five of the lesions (56%) were invasive carcinoma and four (44%) were ductal carcinoma in situ (DCIS). High-risk lesions, including atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH), were found in 6.5 % (4/62) of the lesions, while 3 % (2/62) of the lesions contained lobular carcinoma in situ (LCIS). Cancer plus high risk lesions were found in 15/62 (24%) lesions or 14/50 (28%) of women who underwent biopsy.


CONCLUSIONS
The data in this study supports findings from other studies conducted by large research institutions. In this regard, it is important that community-based hospitals, such as the one operating this breast MR program, can achieve the same positive predictive values as those found in data emanating from academic institutions.
Friedman
Paul
P
Saint Barnabas Medical Center Department of Radiology, Livingston, NJ 07039, USA. pmfriedman@aol.com
Sanders
Linda
L
Russo
Joe
J
Sharo
Ron
R
Swaminathan
Srirama
S
Smith
Robert
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity