title: Breast MRI: patterns of utilization and impact on patient management in the community hospital setting.
abstract: OBJECTIVE
  The objective of our study was to investigate the indications for breast magnetic resonance imaging, or MRI, in our community hospital, determine how many probably benign MRI findings were malignant at follow-up, determine how many cancers were identified by MRI in screening patients, and evaluate the utility of MRI for surgical planning and problem-solving.
  
  
  METHODS
  Five hundred twenty-eight contrast-enhanced MRI's of the breast in 434 patients were retrospectively reviewed. MRI images/reports were compared to surgical pathology reports and the results of follow-up studies.
  
  
  RESULTS
  Screening was the most common indication for breast MRI in our patient population. Five percent of findings termed "probably benign" on MRI proved to be malignant at follow-up. Eight malignancies were detected in six of 202 screened patients. Ten malignancies were diagnosed in 66 patients referred to MRI for problem-solving. In two of 74 patients with known breast cancer, an unsuspected ipsilateral cancer was identified on MRI.
  
  
  CONCLUSIONS
  MRI proved useful in the community hospital setting for screening high-risk patients and problem-solving. The rate of malignancy in probably benign MRI findings was higher than the corresponding rate in mammography. The detection of additional ipsilateral and contralateral cancers in pre-operative patients with known breast cancer was not as high as expected, based on prior studies.
authors.affiliation: Department of Radiology, East Jefferson General Hospital, Metairie, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Lobrano
authors.forename: Alan
authors.initials: A
authors.lastname: Stolier
authors.forename: Robert
authors.initials: R
authors.lastname: L'Hoste
authors.forename: Carol Anne
authors.initials: CA
authors.lastname: Luttrell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery; D019468:Disease Management; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards; D005260:Female; D006764:Hospitals, Community / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards; D008501:Medical Records, Problem-Oriented / Q000706:statistics & numerical data; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies