title: MRI and comparison mammography: a worthy diagnostic alliance for breast microcalcifications?
abstract: BACKGROUND
  There is a lack of data concerning diagnostic performance of magnetic resonance imaging (MRI) in patients with new or increasing microcalcifications.
  
  
  OBJECTIVE
  To evaluate suspicious microcalcifications by using comparison mammography, MRI, and a combination of both methods.
  
  
  METHODS
  Our study group consisted of 55 patients with mammographically detected BI-RADS (Breast Imaging Reporting and Data System) 3-5 microcalcifications for whom comparison mammograms were available. All patients underwent breast MRI before SVAB (stereotactic vacuum-assisted biopsy). Diagnostic performances of comparison mammography and MRI were evaluated, as well as the combination of the respective imaging findings.
  
  
  RESULTS
  Of the 55 microcalcification cases, 35 showed progression and 20 were stable between interval screenings. The negative predictive value (NPV) of comparison mammography was 100%, whereas the NPV of MRI was 92%. However, the specificity of combination of findings was 97%, significantly higher than the 42% specificity of comparison mammography (P < 0.001). Additionally, the positive predictive value of combination of findings was 93% versus 44% of comparison mammography (P = 0.001).
  
  
  CONCLUSIONS
  A biopsy is recommended when MRI positive lesion corresponding the area of new or increasing mammographic microcalcifications is detected. Patients with stable microcalcifications can continue follow-up mammography, regardless of MRI result.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Center Split, Croatia dijanaperica@yahoo.com.
authors.forename: Dijana
authors.initials: D
authors.lastname: Brnic
authors.affiliation: Department of Internal Medicine, University Hospital Center Split, Croatia.
authors.forename: Darko
authors.initials: D
authors.lastname: Brnic
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Center Split, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Simundic
authors.affiliation: Private Dermatovenerology Clinic, Split, Croatia.
authors.forename: Lucija
authors.initials: L
authors.lastname: Vanjaka Rogosic
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Center Split, Croatia.
authors.forename: Tade
authors.initials: T
authors.lastname: Tadic
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002114:Calcinosis / Q000473:pathology*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019786:Gadolinium DTPA
keywords: Magnetic resonance imaging (MRI); comparison; descriptors; mammography; microcalcifications; stability