title: Let's go out of the breast: prevalence of extra-mammary findings and their characterization on breast MRI.
abstract: OBJECTIVE
  The aim of this study is to assess the prevalence, the site and the nature of extra-mammary findings on breast magnetic resonance imaging (MRI) and to determine its accuracy in the characterization of the discovered lesions.
  
  
  METHODS
  A retrospective review of 308 female patients (mean age 50 ± 20) who underwent breast MRI with 1.5T device was performed. 125 out of 308 (40.5%) had a positive personal history of breast cancer (pre-operative n=80; follow-up n=45), while the remaining 183 without history of breast cancer (high familiar risk for breast cancer n=80; dense breast n=103). All incidental findings were characterized by means of additional imaging (US; Bone scintigraphy-MRI; CT-PET-CT).
  
  
  RESULTS
  59 incidental findings were found in 53/308 (17%) examined patients. 9/59 incidental findings (15%) were confirmed to be malignant while the remaining 50/59 (84%) benign. The most common site was the liver (33/59; 55.8%), followed by the lung (6/59; 10.1%), bone (6/59; 10.1%), diaphragm (6/59; 10.1%) spleen (3/59; 5%), kidney (2/59; 3.4%), gall bladder (1/5; 1.5%), ascending aorta (1/59; 1.5%), thyroid (1/59; 1.5%). The incidence of malignant incidental findings resulted to be higher in the group of patients with personal breast cancer (36%) than in the other one (8%). By comparing MRI findings with the additional definitive imaging tools, breast MRI allowed a correct diagnosis in 58/59 cases with a diagnostic accuracy value of 98%.
  
  
  CONCLUSIONS
  Incidental extramammary findings on breast MRI are common. Benign lesions represent the most frequent findings, however malignant ones need to be searched especially in patients with personal history of breast cancer because they could influence the clinical patient management. Breast MRI can characterize incidental findings with high accuracy value.
authors.affiliation: DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, Bari, Italy. Electronic address: marco.moschetta@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Moschetta
authors.affiliation: DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, Bari, Italy. Electronic address: mikitele@hotmail.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Telegrafo
authors.affiliation: DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, Bari, Italy. Electronic address: lea.rella@gmail.com.
authors.forename: Leonarda
authors.initials: L
authors.lastname: Rella
authors.affiliation: DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, Bari, Italy. Electronic address: a.stabile@radiologia.uniba.it.
authors.forename: Amato Antonio
authors.initials: AA
authors.lastname: Stabile Ianora
authors.affiliation: DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, Bari, Italy. Electronic address: g.angellelli@radiologia.uniba.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Angelelli
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D033162:Incidental Findings; D007558:Italy / Q000453:epidemiology; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D015588:Observer Variation; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
keywords: Breast; Incidental findings; MRI