title: Technology Evaluation Center assessment synopsis: use of magnetic resonance imaging to avoid a biopsy in women with suspicious primary breast lesions.
abstract: Imaging technologies (e.g., magnetic resonance imaging [MRI]) have been proposed as noninvasive alternatives to surgical biopsy techniques in the follow-up of women with suspicious primary breast lesions. This article is a synopsis of a systematic review by the Blue Cross and Blue Shield Association Technology Evaluation Center. According to the best available evidence, the sensitivity and specificity of MRI ranged from 91% to 99% and from 31% to 91%, respectively. Predictive values were calculated by using three likely scenarios of diagnostic performance and disease prevalence. The potential harm of failing to diagnose or delaying diagnosis of breast cancer in patients with false-negative MRI results is of significant concern. We conclude that the potential benefit of sparing some patients from unnecessary biopsy by using noninvasive imaging does not outweigh the potential harm of a missed or delayed diagnosis of breast cancer.
authors.affiliation: Technology Evaluation Center, Blue Cross and Blue Shield Association, Chicago, Illinois 60601-7680, USA. carole.flamm@bcbsa.com
authors.forename: Carole Redding
authors.initials: CR
authors.lastname: Flamm
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Ziegler
authors.forename: Naomi
authors.initials: N
authors.lastname: Aronson
mesh_terms: D001707:Biopsy, Needle; D001941:Breast Diseases / Q000175:diagnosis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013673:Technology Assessment, Biomedical