Frequency and Outcomes of Incidental Breast Lesions Detected on Abdominal MRI Over a 7-Year Period.
OBJECTIVE
Our aim was to evaluate the frequency and outcomes of incidental breast lesions detected on abdominal MRI examinations.


METHODS
Abdominal MRI reports for 11,462 women imaged at our institution from November 2007 through December 2014 were reviewed to identify those reporting an incidental breast lesion. Available breast imaging and pathology results were assessed to identify outcomes in these lesions.


RESULTS
Incidental breast lesions were described in the MRI reports of 292 (3%) patients who underwent abdominal MRI during the study period; breast imaging was recommended for 192 of these 292 (66%) patients. Sixty-three of the 192 (33%) patients for whom follow-up breast imaging was recommended underwent such imaging at our institution. Twenty-one of these 63 (33%) lesions underwent biopsy or surgery; histologic sampling of these lesions yielded seven incidental cancers (invasive ductal, n = 6; invasive lobular, n = 1) and 14 benign diagnoses. Three additional cancers (invasive ductal, n = 2; invasive lobular, n = 1) and three benign diagnoses were discovered at pathology at outside institutions. Of the remaining 165 patients without a histologic diagnosis, the lesions in 95 (58%) patients were presumed to be benign because of stability over time. Seven of the 10 patients with a diagnosis of incidental cancer (age range, 53-86 years; mean ± SD, 67.0 ± 10.6 years) had not undergone screening mammography at our institution. The frequency of incidental breast cancer was 11% of patients subsequently undergoing follow-up breast imaging at our institution, 3% of all patients with reported breast lesions, and 0.09% of patients undergoing abdominal MRI examinations.


CONCLUSIONS
Although incidental breast lesions were rarely detected on abdominal MRI, a considerable number of these lesions were found to represent breast cancer, particularly when leading to a recommendation for follow-up breast imaging. Therefore, it is important for radiologists interpreting abdominal MRI examinations to carefully evaluate for the presence of breast abnormalities.
1 Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Ave, New York, NY 10016.
Vinay
V
Prabhu
1 Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Ave, New York, NY 10016.
Chloe M
CM
Chhor
1 Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Ave, New York, NY 10016.
Islamiat O
IO
Ego-Osuala
1 Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Ave, New York, NY 10016.
Jennifer M
JM
Xiao
1 Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Ave, New York, NY 10016.
Nicole M
NM
Hindman
1 Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Ave, New York, NY 10016.
Andrew B
AB
Rosenkrantz
D000005:Abdomen / Q000000981:diagnostic imaging*; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
abdominal MRI; breast; breast cancer; incidental findings; radiology reporting