Background Parenchymal Enhancement on Breast MRI: Impact on Diagnostic Performance

DeMartini, Wendy B.; Liu, Franklin; Peacock, Sue; Eby, Peter R.; Gutierrez, Robert L.; Lehman, Constance D.

doi:10.2214/ajr.10.6272

Cited by 161 publications

(113 citation statements)

References 19 publications

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“…It is in contrast with a study conducted by DeMartini W B et al (12), who found that background parenchymal enhancement were significantly more extensive than older women in younger women.…”

Section: Discussioncontrasting

confidence: 97%

Is Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging Associated with Breast Cancer?

et al. 2018

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Background: Background parenchymal enhancement (BPE) in breast magnetic resonance imaging (MRI) potentially correlates with breast cancer (BC). Thus, BPE may be used for BC risk stratification and for monitoring chemo-prevention. Objectives: We aimed to investigate the BPE patterns in benign and malignant breast lesions and in pre-menopausal and postmenopausal women. Methods: In 2017, 128 consecutive pre-menopausal or post-menopausal patients underwent breast MRI with different indications were examined. Subjects with the history of breast surgery, radiotherapy, or chemotherapy were excluded. A 1.5 Tesla device was used with the same protocol, and a blinded radiologist visually assessed and categorized breast BPE as minimal, mild, moderate, and marked. We used frequency distribution, mean, and standard deviation to report the findings. Comparing age or BPE in categorical variables, we appropriately used ANOVA, or Chi-square and Fisher's exact tests. Results:The mean (± standard deviation) age was 42.43 (± 10.82) years, and 89 (69.5%) patients were hormonally active. Eighteen (14.1%), 55 (43.0%), 41 (32.0%), and 14 (10.9%) patients were classified as having minimal, mild, moderate, and marked BPE, respectively. Age did not change among BPE levels (P = 0.197). Prevalence of moderate and marked BPE was higher in pre-menopausal women. BPE was not associated with breast lesion histopathology (P value = 0.857) in pre-menopausal or post-menopausal women (P = 0.790, and 0.840, respectively). Conclusions: BPE is a measure of breast tissue hormonal activity, and it is not correlated with histopathological diagnosis of breast lesion in both pre-menopausal and post-menopausal women. The data of this study do not support the use of BPE for BC risk estimation.

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Section: Discussioncontrasting

confidence: 97%

Is Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging Associated with Breast Cancer?

et al. 2018

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“…7 The "degree" of BPE is linked to the risk of developing breast cancer, may affect the reading of breast MRI, the staging and the risk of cancer and even the long-term outcome, particularly in patients with certain subtypes at immunohistochemistry. [8][9][10][11][12][13][14][15] BPE can be visually assessed qualitatively using the Breast Imaging-Reporting and Data System (BI-RADS) scores or quantitatively using software. 7,16 However, radiologist agreement for BPE qualitative evaluation is fair 17 and, to the best of our knowledge, there is a lack of uniformity on quantitative measurements of BPE on breast MRI.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of background parenchymal enhancement on breast MRI: a systematic review

Bignotti¹,

Signori²,

Valdora³

et al. 2017

The British Journal of Radiology

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Objective: To perform a systematic review of the methods used for background parenchymal enhancement (BPE) evaluation on breast MRI. Methods: Studies dealing with BPE assessment on breast MRI were retrieved from major medical libraries independently by four reviewers up to 6 October 2015. The keywords used for database searching are "background parenchymal enhancement", "parenchymal enhancement", "MRI" and "breast". The studies were included if qualitative and/or quantitative methods for BPE assessment were described. Results: Of the 420 studies identified, a total of 52 articles were included in the systematic review. 28 studies performed only a qualitative assessment of BPE, 13 studies performed only a quantitative assessment and 11 studies performed both qualitative and quantitative assessments. A wide heterogeneity was found in the MRI sequences and in the quantitative methods used for BPE assessment. Conclusion: A wide variability exists in the quantitative evaluation of BPE on breast MRI. More studies focused on a reliable and comparable method for quantitative BPE assessment are needed. Advances in knowledge: More studies focused on a quantitative BPE assessment are needed.

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“…In our study, BPE associated with BI-RADS scores in all women, including premenopausal ones and women aged 30 -39 years. De Martini et al reported that abnormal interpretation rates for women with moderate or marked BPE were significantly higher than that for women with minimal or mild BPE, but positive biopsy rates were not affected by different BPE [13]. However, in a study by Hambly in women with minimal BPE, no significant difference in BI-RADS category for women with mild, moderate, or marked BPE was found [4].…”

Section: Discussionmentioning

confidence: 97%

“…In contrast to the De Martini et al study [13], we considered the relationships between BPE and the menopausal status variable. Almost quarter of our subjects underwent short-interval follow-ups and rates of short-interval follow-ups did not associate with BPE; these results are in contrast to the previous Hambly study [4].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have suggested that an increased BPE has the possibility to obscure breast lesions and decrease MRI sensitivity for detection of BC or may even be misinterpreted as a suspicious finding itself, thus leading to an increased false-positive biopsy rate and short-interval follow-up rate [4] [10] [11] [12], but some others believe BPE does not significantly affect the diagnostic accuracy of breast MRIs [13]. Imaging material and hormonal status also affect BPE and can limit breast MRI interpretation [14] [15].…”

Section: Introductionmentioning

confidence: 99%

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Is Breast Background Parenchymal Enhancement on MRI Related to BI-RADS Score and Follow-Up Rate?

Alikhassi¹,

Akbari²,

Yazdi³

et al. 2018

ABCR

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Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations from 128 women during a limited time period in 2016 were evaluated. A blinded radiologist visually categorized BPE as minimal, mild, moderate, or marked. A BI-RADS category was also assigned. We used descriptive statistics to report the findings and chi-square and Fisher's exact tests to compare categories. Results: Prevalence of minimal, mild, moderate, and marked BPE was 14.1%, 43.0%, 32.0%, and 10.9%, respectively. The short-interval follow-up rates were 22.2%, 27.3%, 26.8%, and 7.1% in women with minimal, mild, moderate, and marked BPE, respectively. BPE was not associated with the short-interval follow-up rate (p-value = 0.477). Biopsy rates were 22.2%, 27.3%, 22.0%, and 57.1% in women with minimal, mild, moderate, and marked BPE, respectively. Although there was no significant relationship between biopsy rates and BPE levels (p-value = 0.095) in the total population, these two factors were significantly associated in premenopausal women (p-value = 0.023) and in women of 30 -39 years (p-value = 0.001). Conclusion: Higher BPE does not correlate with short-interval follow-up rates, but appears to be related to biopsy rate, thus causing false-positives and unnecessary biopsy recommendations, particularly in younger, premenopausal women.

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Background Parenchymal Enhancement on Breast MRI: Impact on Diagnostic Performance

Abstract: Increased background parenchymal enhancement on breast MRI is associated with younger patient age and higher abnormal interpretation rate. However, it is not related to significant differences in positive biopsy rate, cancer yield, sensitivity, or specificity of MRI.

Cited by 161 publications

References 19 publications

Is Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging Associated with Breast Cancer?

Is Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging Associated with Breast Cancer?

Evaluation of background parenchymal enhancement on breast MRI: a systematic review

Is Breast Background Parenchymal Enhancement on MRI Related to BI-RADS Score and Follow-Up Rate?

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