Incidentally detected lesions on contrast-enhanced MR imaging in candidates for breast-conserving therapy: correlation between MR findings and histological diagnosis.
OBJECTIVE
To investigate the correlation between MR findings and the histological diagnosis of incidentally detected lesions in candidates for breast-conserving therapy.


METHODS
MR images of 299 patients with breast cancer were reviewed. Incidentally detected lesions were noted in 59 of 299 (20%) patients, and a histological diagnosis was obtained in 48 of 59 (81%) patients. There were 25 benign and 23 malignant lesions. The number, size, location, morphologic character, and kinetic curve assessment of the MR findings were analyzed. Statistical analyses were performed to determine whether any differences could be observed between benign and malignant lesions.


RESULTS
Lesions of over 10 mm tended to be malignant (11/16; 69%), whereas those equal or less than 5 mm tended to be benign (12/17; 71%; P < 0.05). Lesions in the same quadrant as the main lesion tended to be malignant (20/27.5; 73%), whereas those in a different quadrant tended to be benign (17.5/20.5; 85%; P < 0.001). Lesions with early peak of enhancement tended to be malignant (20/25; 80%), whereas those with persistent enhancement tended to be benign (20/23; 87%; P < 0.001).


CONCLUSIONS
Incidentally detected lesions that are found in a different quadrant from the main lesion, are smaller than 10 mm in diameter, and show persistent enhancement on MR imaging suggest benign lesions. Therefore, patients with such lesions should avoid unnecessary surgical procedures unless lesions are proved to be malignant by cytology or biopsy.
Yabuuchi
Hidetake
H
Department of Radiology, National Kyushu Cancer Center, Fukuoka, Japan. yabuuchi@radiol.med.kyushu-u.ac.jp
Kuroiwa
Toshiro
T
Kusumoto
Chie
C
Fukuya
Tatsuro
T
Ohno
Shinji
S
Hachitanda
Yoichi
Y
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D018709:Statistics, Nonparametric
D003287:Contrast Media; D019786:Gadolinium DTPA