Predictive values of BI-RADS(®) magnetic resonance imaging (MRI) in the detection of breast ductal carcinoma in situ (DCIS).
OBJECTIVE
The purpose of this study was to evaluate BI-RADS indicators in the detection of DCIS by MRI.


METHODS
Prospective observational study that started in 2014 and lasted 24 months. A total of 110 consecutive patients were evaluated, who presented with suspicious or highly suspicious microcalcifications on screening mammography (BI-RADS categories 4 and 5) and underwent stereotactic-guided breast biopsy, having had an MRI scan performed prior to biopsy.


RESULTS
Altogether, 38 cases were characterized as positive for malignancy, of which 25 were DCIS and 13 were invasive ductal carcinoma cases. MRI had a sensitivity of 96%; specificity of 75.67%; positive predictive value (PPV) for DCIS detection of 57.14%; negative predictive value (NPV) in the detection of DCIS of 98.24%; and an accuracy of 80.80%.


CONCLUSIONS
BI-RADS as a tool for the detection of DCIS by MRI is a powerful instrument whose sensitivity was higher when compared to that observed for mammography in the literature. Likewise, the PPV obtained by MRI was higher than that observed in the present study for mammography, and the high NPV obtained on MRI scans can provide early evidence to discourage breast biopsy in selected cases.
Breast Imaging Service of Radiology Depatment-Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil. Electronic address: gustavobadan@hotmail.com.
Gustavo Machado
GM
Badan
Mastology Division-Gynecology and Obstetrics Department, Brazil.
Sebastião
S
Piato
Breast Imaging Service of Radiology Depatment-Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
Décio
D
Roveda
Breast Imaging Service of Radiology Depatment-Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
Eduardo
E
de Faria Castro Fleury
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002114:Calcinosis / Q000175:diagnosis; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies
Biopsy; Breast; Breast neoplasms; Carcinoma; Intraductal; Large-core needle; Magnetic resonance imaging; Mammography; Noninfiltrating