title: Role of magnetic resonance imaging in probably benign (BI-RADS category 3) microcalcifications of the breast.
abstract: OBJECTIVE
  This study was undertaken to evaluate whether magnetic resonance (MR) imaging is able to rule out malignancy in the case of BI-RADS 3 microcalcifications, providing a sufficient negative predictive value (NPV) for early work-up, and to reduce unnecessary stereotactically guided vacuum-assisted biopsy (SVAB) procedures.
  
  
  METHODS
  We prospectively enrolled consecutive women with BI-RADS 3 microcalcifications, who subsequently underwent MR imaging and SVAB. The MR studies were reviewed according to the MR-BI-RADS classification system; lesions assessed as MR-BI-RADS 1 and 2 were considered negative for malignancy, categories MR-BI-RADS 3, 4 and 5 indicated malignant lesions. The presence of additional findings was recorded. Histologic analysis and follow-up were the reference standard. MR sensitivity, specificity, positive predictive value (PPV) and NPV were calculated.
  
  
  RESULTS
  The final population consisted of 71 lesions. Histologic analysis showed malignancy in six cases (malignancy rate 8%). At MR analysis, 60 (85%) lesions were considered negative for malignancy and 11 (15%) malignant. Additional MR imaging findings were identified in 19 (27%) patients, all corresponding to nonmalignant lesions. MR sensitivity was 33%, specificity 86%, PPV 18% and NPV 93%.
  
  
  CONCLUSIONS
  Because of its relatively low NPV, MR imaging is not able to safely exclude malignancy in the case of BI-RADS 3 microcalcifications. The relatively high malignancy rate found in this study might support SVAB in the case of BI-RADS 3 microcalcifications.
authors.affiliation: Institute of Diagnostic Radiology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, P.le S. Maria della Misericordia, 33100, Udine, Italy, annalinda33@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Linda
authors.forename: Chiara
authors.initials: C
authors.lastname: Zuiani
authors.forename: Viviana
authors.initials: V
authors.lastname: Londero
authors.forename: Eleonora
authors.initials: E
authors.lastname: Di Gaetano
authors.forename: Anna
authors.initials: A
authors.lastname: Dal Col
authors.forename: Rossano
authors.initials: R
authors.lastname: Girometti
authors.forename: Massimo
authors.initials: M
authors.lastname: Bazzocchi
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002114:Calcinosis / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine