Characteristic features and usefulness of MRI in breast cancer in patients under 40 years old: correlations with conventional imaging and prognostic factors

Abstract

Breast cancer in women under 40 years old frequently presents as suspicious masses on both conventional imaging and MRI. Ultrasonography and MRI both showed excellent sensitivities that were better than those of mammography in young women with dense breasts. Additionally, MRI can play an important role in preoperative planning, and some BI-RADS MRI features can be used to predict breast cancer prognosis in this age group.

Breast cancer in very young women (<30 years): Correlation of imaging features with clinicopathological features and immunohistochemical subtypes

“…In our study, the positive predictive value of mammography for diagnosis was 80.5%, which is within the previously reported range (50-90%) [17,18]. The reason for all the false-negative cases was that extremely dense parenchyma obscured the lesion (breast tissue composition, d).…”

“…The revised BI-RADS provides uniform terminology in the lexicon across all three imaging modalities: mammography, ultrasound (US), and magnetic resonance imaging (MRI) [16]. There have been several reports on the radiological features of breast cancer in young women with different age cut-offs [17][18][19], but most studies did not use the revised BI-RADS.…”

Breast cancer diagnosed before the 40 years: imaging findings and correlation with histology and molecular subtype

“…This method has the highest sensitivity to assess the tumor extent and the detection of multifocal and multicentric disease. MRI was also able to indicate a greater number of associated findings, playing an important role in the locoregional staging of breast cancer and its treatment planning [14][15][16][17]. Sardanelli et al [15], showed that MRI was more sensitive (81%) compared to mammography (60%) in the detection of additional tumor foci in nonfatty breasts.…”

Breast Cancer in Adolescent and Young Adult Women

“…1 Suspicious masses are imaged using standard radiologic modalities, including mammography, ultrasonography, and magnetic resonance imaging (MRI), but each has advantages and disadvantages. 43 MRI can lead to unnecessary biopsies because of a lack of specificity, 44 but in general, the sensitivity of MRI and ultrasonography are excellent (100%) and exceed that of mammography (87.4%) in young women. 43 Mammography is not routinely performed because of its ionizing radiation, the decreased sensitivity due to mammographically denser breasts in young women, and the low prevalence of breast cancer in AYA women.…”

“…43 MRI can lead to unnecessary biopsies because of a lack of specificity, 44 but in general, the sensitivity of MRI and ultrasonography are excellent (100%) and exceed that of mammography (87.4%) in young women. 43 Mammography is not routinely performed because of its ionizing radiation, the decreased sensitivity due to mammographically denser breasts in young women, and the low prevalence of breast cancer in AYA women. 45 However, according to the American Cancer Society guidelines, breast density alone is not justification for first-line MRI screening at the current time because of cost.…”