title: Management of breast magnetic resonance imaging-detected lesions.
abstract: Breast magnetic resonance imaging (MRI) has become an essential component of breast imaging. Whether it is used as a problem-solving tool or a screening test or for staging patients with breast cancer, it detects many lesions in the breast. The challenge for the radiologist is to distinguish significant from insignificant lesions and to direct their management. A brief summary of the terminology according to the American College of Radiologists lexicon will be provided. This review article will cover the differential diagnosis of enhancing lesions, including masses and nonmass enhancement, from benign and malignant causes. Some of the specific morphologic and kinetic features that help to differentiate benign from malignant lesions will be illustrated, and positive predictive values of these features will be reviewed. The various methods of investigating enhancing lesions of the breast will be discussed, including second-look ultrasound, ultrasound-guided biopsy, stereotactic biopsy, and MRI-guided biopsy. A practical approach to the management of MRI-detected lesions will include timing of follow-up, when to biopsy and when to ignore enhancing lesions in the breast.
authors.affiliation: Division of Breast Imaging, Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada. jeseely@ottawahospital.on.ca
authors.forename: Jean M
authors.initials: JM
authors.lastname: Seely
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D053783:Magnetic Resonance Imaging, Interventional; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D009626:Terminology as Topic; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media