Background parenchymal enhancement over exam time in patients with and without breast cancer.
To compare background parenchymal enhancement (BPE) over time in patients with and without breast cancer.



This retrospective Institutional Review Board (IRB)-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant study included 116 women (25-84 years, mean 54 years) with breast cancer who underwent breast magnetic resonance imaging at 3T between 1/2/2009 and 12/29/2009 and 116 age and date-of-exam-matched women without breast cancer (23-84 years, mean 51 years). Two independent, blinded readers (R1, R2) recorded BPE (minimal, mild, moderate, marked) at three times (100, 210, and 320 seconds postcontrast). Subsequent cancers were diagnosed in 9/96 control patients with follow up (12.6-93.0 months, mean 63.6 months). Exact Mann-Whitney, Fisher's exact, and McNemar tests were performed.



Mean BPE was not found to be different between patients with and without breast cancer at any time (P = 0.36-0.64). At time 2 as compared with time 1, there were significantly more patients, both with and without breast cancer, with BPE >minimal (R1: 90 vs. 41 [P < 0.001] and 81 vs. 36 [P < 0.001]; R2: 84 vs. 52 [P < 0.001] and 79 vs. 43 [P < 0.001]) and BPE >mild (R1: 59 vs. 10 [P < 0.001] and 47 vs. 13 [P < 0.001]; R2: 49 vs. 12 [P < 0.001] and 41 vs. 18 [P < 0.001]). BPE changes between times 2 and 3 were not significant (P = 0.083-1.0). Odds ratios for control patients developing breast cancer were significant only for R2 and ranged up to 7.67 (1.49, 39.5; P < 0.01) for BPE >mild at time 2.



BPE changes between the first and second postcontrast scans and stabilizes thereafter in most patients. Further investigation into the most clinically relevant timepoint for BPE assessment is warranted.



3 J. Magn. Reson. Imaging 2017;45:74-83.
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
Amy
A
Melsaether
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
Akshat C
AC
Pujara
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
Kristin
K
Elias
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
Kristine
K
Pysarenko
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
Anjali
A
Gudi
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
Katerina
K
Dodelzon
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
James S
JS
Babb
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.
Yiming
Y
Gao
Department of Radiology, NYU Perlmutter Cancer Center, New York University School of Medicine, New York, New York, USA.|Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI(2)R), New York University School of Medicine, New York, New York, USA.
Linda
L
Moy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
background parenchymal enhancement; breast MRI; breast cancer; breast cancer risk