title: Accuracy of magnetic resonance in suspicious breast lesions: a systematic quantitative review and meta-analysis.
abstract: Dynamic contrast-enhanced breast magnetic resonance (MR) is a promising emerging technique for evaluating breast lesions. A quantitative systematic review was performed to estimate the accuracy of breast MR in the diagnosis of high-risk breast lesions and breast cancer. A comprehensive search of the Cochrane Library, MEDLINE, CANCERLIT, LILACS, and EMBASE databases was performed from January 1985 to August 2010. The medical subjects heading (MeSH) and text words for the terms "breast neoplasm", "breast lesions", "breast cancer" and "magnetic resonance" were combined with the MeSH term diagnosis ("sensitivity and specificity"). Studies that compared breast MR with paraffin-embedded sections parameters for the diagnosis of breast lesions (benign, high-risk borderline, and breast cancer) were included. Sixty-nine studies were analyzed, which included 9,298 women with 9,884 breast lesions. Interrater overall agreement between breast MR and paraffin section diagnosis was 79% (κ = 0.55), indicating moderate agreement. Pooled sensitivity and specificity were 90% [95% CI 88-92%] and 75% [95% CI 70-79%], respectively. The pooled likelihood positive ratio was 3.64 (95% CI 3.0-4.2) and the negative ratio was 0.12 (95% CI 0.09-0.15). For breast cancer or high-risk lesions versus benign lesions, the AUC was 0.91 for breast MR and the point Q* was 0.84. In summary, breast MR is a useful pre-operative test for predicting the diagnosis of breast lesions.
authors.affiliation: Postgraduate Program in Medicine, Medical Sciences at Federal University of Rio Grande do Sul, Porto Alegre, Brazil. lidia.rosi@terra.com.br
authors.forename: Lidia Rosi
authors.initials: LR
authors.lastname: Medeiros
authors.forename: Célia Scapin
authors.initials: CS
authors.lastname: Duarte
authors.forename: Daniela Dornelles
authors.initials: DD
authors.lastname: Rosa
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Edelweiss
authors.forename: Marcia
authors.initials: M
authors.lastname: Edelweiss
authors.forename: Fábio Rosa
authors.initials: FR
authors.lastname: Silva
authors.forename: Erik Paul
authors.initials: EP
authors.lastname: Winnnikow
authors.forename: Patrícia Duarte
authors.initials: PD
authors.lastname: Simões Pires
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Rosa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008875:Middle Aged; D012372:ROC Curve; D055815:Young Adult