The ability of mammography and magnetic resonance imaging (MRI) to predict residual malignancy after excisional biopsy for microcalcifications and whether background parenchymal enhancement (BPE) on MRI influences diagnostic performance was assessed in 51 patients. MRI was more accurate than mammography; however, BPE decreased the diagnostic performance of MRI. Patients with breast cancer with moderate or marked BPE require careful assessment. Background: Whether surgery should be performed after excisional biopsy based on mammography or magnetic resonance imaging (MRI) findings has not been evaluated for breast cancer with suspicious microcalcifications on mammography. This study investigated the ability of mammography and MRI to predict residual malignancy after excisional biopsy for suspicious microcalcifications and whether background parenchymal enhancement (BPE) influences the diagnostic performance of MRI. Patients and Methods: Fifty-one patients with breast cancer who underwent excisional biopsy for suspicious microcalcifications between January 2009 and February 2019 were enrolled in this single-center retrospective study. Two expert readers independently evaluated the ability of mammography and MRI to predict residual malignancy at the surgical site. The diagnostic value of mammography and MRI was evaluated using histopathology as the standard. Results: Thirty-two patients had residual malignancy. The average overall sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the curve for residual malignancy were 78.

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