title: Is a one-year follow-up an efficient method for better management of MRI BI-RADS(®) 3 lesions?
abstract: OBJECTIVE
  To evaluate the necessity of a prolonged follow-up after one year for lesions incidentally diagnosed as Breast Imaging Reporting and Data System (BI-RADS)(®) 3 on magnetic resonance imaging (MRI).
  
  
  METHODS
  Institutional review board approved this study (CRC_june 2014_ project 11). We retrospectively analysed 218 consecutive MRI BI-RADS(®) 3 lesions in 110 women followed-up at 6, 12, 18 and/or 24 months from 2011 through to 2015. We excluded MRI scans of BRCA mutation carriers, in staging before treatment and in patients undergoing therapy for breast cancer. Second-look ultrasound and mammography were normal. We analysed 43 masses, 46 foci and 129 non-mass enhancements. In the follow-up, the image was scored as BI-RADS(®) 2 if it was completely resolved, BI-RADS(®) 3 if it was stable, and BI-RADS(®) 4 if a suspicious change occurred.
  
  
  RESULTS
  Forty-four lesions (20%) completely resolved during the follow-up. Six were scored as BI-RADS(®) 4: five at 6 months (benign) and one at 12 months (8 mm invasive ductal carcinoma). One hundred and sixty eight stable lesions were assigned BI-RADS(®) 2 at 18 or 24 months. The predictive positive value of cancer for BI-RADS(®) 3 lesions is 0.5% (95% CI [0.08-2.55]) in our study.
  
  
  CONCLUSIONS
  Our results suggest that a one year follow-up instead of two years is sufficient for BI-RADS 3 lesions, in case of using rigorous inclusion criteria. Given the very low PPV of the BI-RADS(®) 3 lesions incidentally found on MRI, further studies with very large inclusions are necessary to establish new guidelines for MRI follow-up.
authors.affiliation: Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000 Bordeaux, France. Electronic address: m.boisserie-lacroix@bordeaux.unicancer.fr.
authors.forename: Martine
authors.initials: M
authors.lastname: Boisserie-Lacroix
authors.affiliation: Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000 Bordeaux, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Ziadé
authors.affiliation: Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000 Bordeaux, France.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Hurtevent-Labrot
authors.affiliation: Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000 Bordeaux, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Ferron
authors.affiliation: Clinical and Epidemiological Research Unit, Institut Bergonié, F-33000 Bordeaux, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Brouste
authors.affiliation: Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000 Bordeaux, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lippa
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016217:Ultrasonography, Mammary; D055815:Young Adult
keywords: BI-RADS(®) 3; Breast cancer; Follow-up; Magnetic resonance imaging