title: Low rates of additional cancer detection by magnetic resonance imaging in newly diagnosed breast cancer patients who undergo preoperative mammography and ultrasonography.
abstract: OBJECTIVE
  We evaluated the efficacy of breast magnetic resonance imaging (MRI) for detecting additional malignancies in breast cancer patients newly diagnosed by breast ultrasonography and mammography.
  
  
  METHODS
  We retrospectively reviewed the records of 1,038 breast cancer patients who underwent preoperative mammography, bilateral breast ultrasonography, and subsequent breast MRI between August 2007 and December 2010 at single institution in Korea. MRI-detected additional lesions were defined as those lesions detected by breast MRI that were previously undetected by mammography and ultrasonography and which would otherwise have not been identified.
  
  
  RESULTS
  Among the 1,038 cases, 228 additional lesions (22.0%) and 30 additional malignancies (2.9%) were detected by breast MRI. Of these 228 lesions, 109 were suspected to be malignant (Breast Imaging-Reporting and Data System category 4 or 5) on breast MRI and second-look ultrasonography and 30 were pathologically confirmed to be malignant (13.2%). Of these 30 lesions, 21 were ipsilateral to the main lesion and nine were contralateral. Fourteen lesions were in situ carcinomas and 16 were invasive carcinomas. The positive predictive value of breast MRI was 27.5% (30/109). No clinicopathological factors were significantly associated with additional malignant foci.
  
  
  CONCLUSIONS
  Breast MRI was useful in detecting additional malignancy in a small number of patients who underwent ultrasonography and mammography.
authors.affiliation: Division of Breast-Endocrine Surgery, Department of Surgery, Asan Medical Center, Seoul, Korea.
authors.forename: Jisun
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Wonshik
authors.initials: W
authors.lastname: Han
authors.affiliation: Department of Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyeong-Gon
authors.initials: HG
authors.lastname: Moon
authors.affiliation: Department of Surgery, Mamms Clinic, Seoul, Korea.
authors.forename: Soo Kyung
authors.initials: SK
authors.lastname: Ahn
authors.affiliation: Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hee-Chul
authors.initials: HC
authors.lastname: Shin
authors.affiliation: Department of Surgery, Sun General Hospital, Daejeon, Korea.
authors.forename: Jee-Man
authors.initials: JM
authors.lastname: You
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chang
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Nariya
authors.initials: N
authors.lastname: Cho
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
authors.affiliation: Department of Pathology, Seoul National University Hospital, Seoul, Korea.
authors.forename: In-Ae
authors.initials: IA
authors.lastname: Park
authors.affiliation: Department of Surgery, Mamms Clinic, Seoul, Korea.
authors.forename: Dong-Young
authors.initials: DY
authors.lastname: Noh
keywords: Breast neoplasms; Limit of detection; Magnetic resonance imaging; Ultrasonography