title: Frequency and Clinical Significance of Extramammary Findings on Breast Magnetic Resonance Imaging.
abstract: Use of breast magnetic resonance imaging (MRI) for screening and local staging of breast cancer has increased. With this, questions have emerged regarding the management and effect of extramammary findings (EMFs) reported on breast MRI.
  
  
  
  Breast MRI studies performed between January 1, 2007 and December 31, 2012 at the University of Iowa were analyzed. Data were collected regarding number and location of EMFs, characteristics of the patients who had a breast MRI, and time to first treatment among the patients who had a breast MRI for stage I-III breast cancer.
  
  
  
  During the study period, 1305 breast MRIs were obtained in 772 women. An EMF was found in 140 studies (10.7%) and 113 women (14.6%). EMFs were more likely in MRIs of older patients (50 vs. 54 years, P = .004) and postmenopausal women (P = .001). Anatomically, most EMFs were seen in the liver (89 of 140) or bone (21 of 140). Eight women (0.6%) had an EMF on breast MRI that led to upstaging to stage IV breast cancer. For patients with stage I-III breast cancer, the finding of an EMF on breast MRI did not affect time to initial cancer treatment (13 vs. 14 days; P = .586).
  
  
  
  EMFs on breast MRI are seen with some frequency and occur more commonly in older, postmenopausal women. In our study, most EMFs were benign and did not affect patient outcome with regard to upstaging to stage IV disease or time to cancer treatment. A very small portion of studies revealed subclinical advanced breast cancer.
authors.affiliation: Division of Hematology, Oncology, and Blood and Marrow Transplantation, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA.
authors.forename: Sneha
authors.initials: S
authors.lastname: Phadke
authors.affiliation: Division of Hematology, Oncology, and Blood and Marrow Transplantation, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA.
authors.forename: Limin
authors.initials: L
authors.lastname: Yang
authors.affiliation: Division of Hematology, Oncology, and Blood and Marrow Transplantation, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA; Oncology Specialists of Charlotte, Charlotte, NC.
authors.forename: Catherine
authors.initials: C
authors.lastname: Moore
authors.affiliation: Division of Hematology, Oncology, and Blood and Marrow Transplantation, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA; ProMedica Hematology/Oncology Associates, Sylvania, OH.
authors.forename: Chang
authors.initials: C
authors.lastname: Xia
authors.affiliation: Division of Health Services Research, Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA. Electronic address: mary-schroeder@uiowa.edu.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Schroeder
mesh_terms: D000367:Age Factors; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D061665:Time-to-Treatment
keywords: Breast MRI; Breast neoplasm; Incidental finding; Time to initial treatment; Upstaging